Provider Demographics
NPI:1457589376
Name:SMITH, AMY B (AUD,CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:B
Last Name:SMITH
Suffix:
Gender:F
Credentials:AUD,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 HOUMA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4278
Mailing Address - Country:US
Mailing Address - Phone:504-454-3277
Mailing Address - Fax:504-887-8934
Practice Address - Street 1:3434 HOUMA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4278
Practice Address - Country:US
Practice Address - Phone:504-454-3277
Practice Address - Fax:504-887-8934
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6132237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1810100Medicaid
LA3B314Medicare PIN