MEDICARE: SABRINA TEMPLET SIMONEAUX AU.D.

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	231H00000X	Audiologist	AY1356	FL
2	237600000X	Audiologist-Hearing Aid Fitter	6014	LA

General Provider Information

NPI Number	:	1962474999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA TEMPLET SIMONEAUX AU.D.

Provider Business Mailing Address
First Line	:	4451 BLUEBONNET BLVD
Second Line	:	SUITE G
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-9646
Country	:	US
Telephone Number	:	225-663-6130
Fax Number	:	225-757-6559

Provider Business Practice Location Address
First Line	:	4451 BLUEBONNET BLVD
Second Line	:	SUITE G
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-9646
Country	:	US
Telephone Number	:	225-663-6130
Fax Number	:	225-757-6559

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	04/02/2009

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