MEDICARE: CASEY RENEE CAMBRE M.S., L/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
1	235Z00000X	Speech-Language Pathologist	6208	LA

General Provider Information

NPI Number	:	1881248714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY RENEE CAMBRE M.S., L/CCC-SLP

Provider Business Mailing Address
First Line	:	18750 LA HIGHWAY 16
Second Line	:
City	:	PORT VINCENT
State	:	LA
Zip	:	70726-8051
Country	:	US
Telephone Number	:	225-241-7335
Fax Number	:

Provider Business Practice Location Address
First Line	:	18750 LA HIGHWAY 16
Second Line	:
City	:	PORT VINCENT
State	:	LA
Zip	:	70726-8051
Country	:	US
Telephone Number	:	225-241-7335
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2019
Last Update Date	:	07/29/2019

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Directions to “ CASEY RENEE CAMBRE M.S., L/CCC-SLP” Practice Location

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