Healthcare Provider Details

I. General information

NPI: 1184308215
Provider Name (Legal Business Name): PEYTON POIRIER ROBERTS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 SCHOOL ST
BREAUX BRIDGE LA
70517-6833
US

IV. Provider business mailing address

209 TENNYSON DR
BROUSSARD LA
70518-5355
US

V. Phone/Fax

Practice location:
  • Phone: 337-909-3900
  • Fax:
Mailing address:
  • Phone: 337-201-5905
  • Fax: 337-660-2241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: