Provider Demographics
NPI:1003133430
Name:HEBERT, BRANDI B (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:B
Last Name:HEBERT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13209 JOYCELYNN RD
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-4037
Mailing Address - Country:US
Mailing Address - Phone:225-202-1669
Mailing Address - Fax:
Practice Address - Street 1:13209 JOYCELYNN RD
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-4037
Practice Address - Country:US
Practice Address - Phone:225-202-1669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-25
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist