Healthcare Provider Details

I. General information

NPI: 1396167383
Provider Name (Legal Business Name): ALLYSON PARDEN KELLER M.S., CCC-A, FAAA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 09/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OCHSNER BLVD
COVINGTON LA
70433-8107
US

IV. Provider business mailing address

7009 MEADOWBROOK DR
MANDEVILLE LA
70471-7404
US

V. Phone/Fax

Practice location:
  • Phone: 985-875-2816
  • Fax:
Mailing address:
  • Phone: 813-240-1551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number4247
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: