Provider Demographics
NPI:1922648351
Name:EICHLER, ANNA KAYE BERRY
Entity Type:Individual
Prefix:
First Name:ANNA KAYE
Middle Name:BERRY
Last Name:EICHLER
Suffix:
Gender:F
Credentials:
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 1077
Mailing Address - Street 2:
Mailing Address - City:NEW ROADS
Mailing Address - State:LA
Mailing Address - Zip Code:70760-1077
Mailing Address - Country:US
Mailing Address - Phone:319-270-4551
Mailing Address - Fax:
Practice Address - Street 1:7756 COOKS LANDING DR
Practice Address - Street 2:
Practice Address - City:VENTRESS
Practice Address - State:LA
Practice Address - Zip Code:70783-4127
Practice Address - Country:US
Practice Address - Phone:319-270-4551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1537235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist