Provider Demographics
NPI:1902884836
Name:BODE, DANIEL PAUL (AUD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:BODE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:433 METAIRIE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4324
Mailing Address - Country:US
Mailing Address - Phone:504-833-4327
Mailing Address - Fax:504-833-4768
Practice Address - Street 1:433 METAIRIE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4324
Practice Address - Country:US
Practice Address - Phone:504-833-4327
Practice Address - Fax:504-833-4768
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA785237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1971430Medicaid