Provider Demographics
NPI:1952043986
Name:CARMOUCHE, DEBRA BROWN
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:BROWN
Last Name:CARMOUCHE
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 2158
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70502-2158
Mailing Address - Country:US
Mailing Address - Phone:337-521-7000
Mailing Address - Fax:337-521-7115
Practice Address - Street 1:113 CHAPLIN DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-2101
Practice Address - Country:US
Practice Address - Phone:337-521-7000
Practice Address - Fax:337-521-7115
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist