Provider Demographics
NPI:1528230471
Name:NEAL, BRANDY L (ST)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:L
Last Name:NEAL
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-0880
Mailing Address - Country:US
Mailing Address - Phone:225-687-2066
Mailing Address - Fax:225-687-2067
Practice Address - Street 1:59295 RIVER WEST DRIVE
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764
Practice Address - Country:US
Practice Address - Phone:225-687-2066
Practice Address - Fax:225-687-2067
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5545235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist