Provider Demographics
NPI:1598121071
Name:BOUDREAUX, MEREDITH HOBGOOD (AUD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:HOBGOOD
Last Name:BOUDREAUX
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41161 MARSH LN
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-8649
Mailing Address - Country:US
Mailing Address - Phone:225-229-7978
Mailing Address - Fax:
Practice Address - Street 1:41161 MARSH LN
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-8649
Practice Address - Country:US
Practice Address - Phone:225-229-7978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80809231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80809OtherAUDIOLOGY LICENSE NUMBER
LA9476OtherAUDIOLOGY LICENSE NUMBER