Provider Demographics
NPI:1609091867
Name:OPELOUSAS SPEECH AND HEARING CENTER
Entity Type:Organization
Organization Name:OPELOUSAS SPEECH AND HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST AND SPEECH PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUILLORY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:337-942-3451
Mailing Address - Street 1:318 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-5246
Mailing Address - Country:US
Mailing Address - Phone:337-942-3451
Mailing Address - Fax:337-942-3414
Practice Address - Street 1:318 W NORTH ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-5246
Practice Address - Country:US
Practice Address - Phone:337-942-3451
Practice Address - Fax:337-942-3414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA56332B00000X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4600002OtherAUDIOLOGIST
LA1308889Medicaid
LA47936Medicare ID - Type UnspecifiedSPEECH PATHOLOGIST
LA56062Medicare ID - Type UnspecifiedAUDIOLOGIST