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General NPI Number Information
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NPI Number | 1497549190
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Entity Type | Individual
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Provider Name | LAURA AUGUST JANDREAU
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Gender | Female
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 2701 CHESTNUT STATION CT
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City | LOUISVILLE
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State | KY
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Zip | 40299-6395
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Country | US
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Telephone | 800-335-1060
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Fax |
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Provider Business Mailing Address
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Address Line | 300 N BROOKFIELD RD
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City | BARRE
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State | MA
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Zip | 01005-9042
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Country | US
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Telephone | 515-657-3565
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Fax |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP100886
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License Number State | MA
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