Healthcare Provider Details

I. General information

NPI: 1255511929
Provider Name (Legal Business Name): AUDIOLOGY ASSOCIATES OF ACADIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 EXCHANGE PL SUITE 100
LAFAYETTE LA
70503-2510
US

IV. Provider business mailing address

110 EXCHANGE PL SUITE 100
LAFAYETTE LA
70503-2510
US

V. Phone/Fax

Practice location:
  • Phone: 337-291-9939
  • Fax:
Mailing address:
  • Phone: 337-291-9939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3314
License Number StateLA

VIII. Authorized Official

Name: DR. ERICA LYNN LEE
Title or Position: PRESIDENT
Credential: AU.D, CCC-A
Phone: 337-291-9939