Provider Demographics
NPI:1093970311
Name:TAYLOR-JEANFREAU, JENNIFER A (AUD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:TAYLOR-JEANFREAU
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 BELLE TERRE BLVD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-4734
Mailing Address - Country:US
Mailing Address - Phone:985-237-4067
Mailing Address - Fax:484-727-0550
Practice Address - Street 1:15813 PAUL VEGA DR
Practice Address - Street 2:SUITE 301
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1426
Practice Address - Country:US
Practice Address - Phone:985-230-2630
Practice Address - Fax:985-230-2634
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4553231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist