Provider Demographics
NPI:1275714388
Name:ROBERTS, TERRY L (AUD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4007 PARLIAMENT DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3018
Mailing Address - Country:US
Mailing Address - Phone:318-442-9812
Mailing Address - Fax:318-449-4985
Practice Address - Street 1:4007 PARLIAMENT DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3018
Practice Address - Country:US
Practice Address - Phone:318-442-9812
Practice Address - Fax:318-449-4985
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2580237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter