Provider Demographics
NPI:1922140144
Name:JUNEAU, KIM KAYLA (AUD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:KAYLA
Last Name:JUNEAU
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:KAYLA
Other - Last Name:GOUDREAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:134 VILLERE DR
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-2508
Mailing Address - Country:US
Mailing Address - Phone:504-733-3767
Mailing Address - Fax:504-733-3799
Practice Address - Street 1:175 BROOKHOLLOW ESPLANADE
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123
Practice Address - Country:US
Practice Address - Phone:504-733-3767
Practice Address - Fax:504-733-3799
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3234237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter