Healthcare Provider Details

I. General information

NPI: 1679498943
Provider Name (Legal Business Name): SYDNEY LEE MUNIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 RUE SIMONE
HAMMOND LA
70403-5728
US

IV. Provider business mailing address

2106 RUE SIMONE
HAMMOND LA
70403-5728
US

V. Phone/Fax

Practice location:
  • Phone: 985-662-5448
  • Fax: 985-222-2571
Mailing address:
  • Phone: 985-662-5448
  • Fax: 985-222-2571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10265
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: