Healthcare Provider Details

I. General information

NPI: 1538915533
Provider Name (Legal Business Name): ANDREA OLIVIER LEDEE MS, PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 CAILLOUETT PL
LAFAYETTE LA
70501-7807
US

IV. Provider business mailing address

1093 SONNIER DR
CHURCH POINT LA
70525-5420
US

V. Phone/Fax

Practice location:
  • Phone: 337-366-1801
  • Fax:
Mailing address:
  • Phone: 337-308-1160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC9699
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: