Provider Demographics
NPI:1255530705
Name:BAUCUM, BILLY KAY (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BILLY
Middle Name:KAY
Last Name:BAUCUM
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 FAIRMONT ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-1049
Mailing Address - Country:US
Mailing Address - Phone:225-387-0423
Mailing Address - Fax:
Practice Address - Street 1:1515 FAIRMONT ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-1049
Practice Address - Country:US
Practice Address - Phone:225-387-0423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA489235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist