Provider Demographics
NPI:1346941176
Name:BROYARD, JENNIFER BERNADETTE (MCD, CCC A/SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BERNADETTE
Last Name:BROYARD
Suffix:
Gender:F
Credentials:MCD, CCC A/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7441 SEVEN OAKS RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2230
Mailing Address - Country:US
Mailing Address - Phone:504-931-6069
Mailing Address - Fax:
Practice Address - Street 1:2401 WESTBEND PKWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-2458
Practice Address - Country:US
Practice Address - Phone:504-931-6069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1245235Z00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist