Provider Demographics
NPI:1205615507
Name:BRASSEAUX, ALISON CHAMPAGNE (SLP)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:CHAMPAGNE
Last Name:BRASSEAUX
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 MARKS LN
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-7628
Mailing Address - Country:US
Mailing Address - Phone:337-789-3808
Mailing Address - Fax:
Practice Address - Street 1:202 RUE IBERVILLE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3295
Practice Address - Country:US
Practice Address - Phone:337-789-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist