Provider Demographics
NPI:1225485600
Name:BREAUX, LEZLI M (MA, CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:LEZLI
Middle Name:M
Last Name:BREAUX
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7142 ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:JARREAU
Mailing Address - State:LA
Mailing Address - Zip Code:70749-3009
Mailing Address - Country:US
Mailing Address - Phone:504-432-3060
Mailing Address - Fax:
Practice Address - Street 1:7142 ISLAND RD
Practice Address - Street 2:
Practice Address - City:JARREAU
Practice Address - State:LA
Practice Address - Zip Code:70749-3009
Practice Address - Country:US
Practice Address - Phone:504-432-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist