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NPI Code Detail

MEDICARE: ROBIN BROUSSARD CONSTANT MCD, CCC-SLP

MEDICARE: ROBIN BROUSSARD CONSTANT MCD, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2368LA

General Provider Information

NPI Number : 1770704082
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBIN BROUSSARD CONSTANT MCD, CCC-SLP
Provider Business Mailing Address
First Line : 569 KENMORE DR
Second Line :
City : HARAHAN
State : LA
Zip : 70123-3825
Country : US
Telephone Number : 504-818-2204
Fax Number : 504-818-2204
Provider Business Practice Location Address
First Line : 6001 AIRLINE DR
Second Line :
City : METAIRIE
State : LA
Zip : 70003-4330
Country : US
Telephone Number : 504-818-2204
Fax Number : 504-818-2204
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 07/08/2007

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Directions to “ ROBIN BROUSSARD CONSTANT MCD, CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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