Provider Demographics
NPI:1649449984
Name:BOUDREAUX, MONICA REINA (AUD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:REINA
Last Name:BOUDREAUX
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:REINA
Other - Last Name:VALLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:101 LOTTIE LN STE 2
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-7309
Mailing Address - Country:US
Mailing Address - Phone:251-990-0535
Mailing Address - Fax:251-990-0538
Practice Address - Street 1:8154 HWY 59, SUITE 202
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535
Practice Address - Country:US
Practice Address - Phone:251-971-1152
Practice Address - Fax:251-990-0538
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7017231H00000X, 237700000X
AL1247A237600000X, 231H00000X
237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist