Healthcare Provider Details

I. General information

NPI: 1659102432
Provider Name (Legal Business Name): ANGELA HEBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5922 W MAIN ST
HOUMA LA
70360-1715
US

IV. Provider business mailing address

5750 JOHNSTON ST STE 502
LAFAYETTE LA
70503-5334
US

V. Phone/Fax

Practice location:
  • Phone: 985-876-9076
  • Fax:
Mailing address:
  • Phone: 337-704-2228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: