Healthcare Provider Details

I. General information

NPI: 1841581139
Provider Name (Legal Business Name): KIMBERLY SETTOON LEBLANC MA, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2011
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8080 BLUEBONNET BLVD
BATON ROUGE LA
70810-7827
US

IV. Provider business mailing address

604 NORTH ACADIA STE 101
THIBODAUX LA
70301-4897
US

V. Phone/Fax

Practice location:
  • Phone: 225-767-7200
  • Fax: 225-767-7386
Mailing address:
  • Phone: 985-446-5079
  • Fax: 985-447-2497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number3618A
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: