Healthcare Provider Details

I. General information

NPI: 1457589376
Provider Name (Legal Business Name): AMY B. SMITH AU.D.,CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 HOUMA BLVD SUITE 201
METAIRIE LA
70006-4278
US

IV. Provider business mailing address

3434 HOUMA BLVD SUITE 201
METAIRIE LA
70006-4278
US

V. Phone/Fax

Practice location:
  • Phone: 504-454-3277
  • Fax: 504-887-8934
Mailing address:
  • Phone: 504-454-3277
  • Fax: 504-887-8934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number6132
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number6132
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: