Provider Demographics
NPI:1679011050
Name:SPEYRER, CALEB (BS)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:SPEYRER
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 ULLOA ST
Mailing Address - Street 2:APT N
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6901
Mailing Address - Country:US
Mailing Address - Phone:337-280-2334
Mailing Address - Fax:
Practice Address - Street 1:4051 ULLOA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6833
Practice Address - Country:US
Practice Address - Phone:504-267-5712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician