Provider Demographics
NPI:1316229933
Name:SIMONEAUX, MEGHAN BERNADETTE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:BERNADETTE
Last Name:SIMONEAUX
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-1943
Mailing Address - Country:US
Mailing Address - Phone:504-349-8677
Mailing Address - Fax:
Practice Address - Street 1:4600 RIVER RD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-1943
Practice Address - Country:US
Practice Address - Phone:504-349-8677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6134235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist