Provider Demographics
NPI:1497871040
Name:PREJEAN, AIMEE
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:
Last Name:PREJEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 MECHE RD
Mailing Address - Street 2:
Mailing Address - City:ARNAUDVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70512-6524
Mailing Address - Country:US
Mailing Address - Phone:337-278-5903
Mailing Address - Fax:
Practice Address - Street 1:100 WILLIAM O STUTES ST
Practice Address - Street 2:SUITE A
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-7211
Practice Address - Country:US
Practice Address - Phone:337-406-0712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist