Healthcare Provider Details

I. General information

NPI: 1558939413
Provider Name (Legal Business Name): ASHLEY DRONET MEJIA AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 PATRIOT ST STE 204
LAFAYETTE LA
70508-6831
US

IV. Provider business mailing address

PO BOX 52068
LAFAYETTE LA
70505-2068
US

V. Phone/Fax

Practice location:
  • Phone: 337-456-1106
  • Fax:
Mailing address:
  • Phone: 337-456-1106
  • Fax: 337-456-1108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number8871
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: