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General NPI Number Information
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NPI Number | 1447741343
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Entity Type | Individual
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Provider Name | CAMILLE ELEAZAR BERRY AUD
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Gender | Female
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 5000 AMBASSADOR CAFFERY PKWY BLDG 3
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City | LAFAYETTE
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State | LA
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Zip | 70508-6984
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Country | US
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Telephone | 337-991-0010
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Fax | 337-991-2465
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Provider Business Mailing Address
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Address Line | 604 N ACADIA RD STE 101
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City | THIBODAUX
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State | LA
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Zip | 70301-4897
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Country | US
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Telephone | 985-446-5079
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Fax | 985-447-2497
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 8105
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License Number State | LA
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