Healthcare Provider Details

I. General information

NPI: 1962474999
Provider Name (Legal Business Name): SABRINA TEMPLET SIMONEAUX AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4451 BLUEBONNET BLVD SUITE G
BATON ROUGE LA
70809-9646
US

IV. Provider business mailing address

4451 BLUEBONNET BLVD SUITE G
BATON ROUGE LA
70809-9646
US

V. Phone/Fax

Practice location:
  • Phone: 225-663-6130
  • Fax: 225-757-6559
Mailing address:
  • Phone: 225-663-6130
  • Fax: 225-757-6559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1356
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number6014
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: