Provider Demographics
NPI:1316142284
Name:BENOIT, ALYCE T (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:ALYCE
Middle Name:T
Last Name:BENOIT
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2002 JOHNSON ST
Mailing Address - Street 2:STE 100
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-3640
Mailing Address - Country:US
Mailing Address - Phone:337-824-4547
Mailing Address - Fax:337-824-4548
Practice Address - Street 1:312 GUILBEAU RD
Practice Address - Street 2:SUITE 4B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6952
Practice Address - Country:US
Practice Address - Phone:337-981-9940
Practice Address - Fax:337-981-2531
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5641235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist