Healthcare Provider Details

I. General information

NPI: 1568069953
Provider Name (Legal Business Name): BRITTANY COMEAUX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 10/08/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29849 S MAGNOLIA ST
LIVINGSTON LA
70754
US

IV. Provider business mailing address

1516 RUE DESIREE
BATON ROUGE LA
70810-3151
US

V. Phone/Fax

Practice location:
  • Phone: 225-686-7600
  • Fax:
Mailing address:
  • Phone: 225-931-9150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: