Provider Demographics
NPI:1881248714
Name:CAMBRE, CASEY RENEE (MS, L/CCC-SLP)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:RENEE
Last Name:CAMBRE
Suffix:
Gender:F
Credentials:MS, L/CCC-SLP
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:RENEE
Other - Last Name:BARRILLEAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18750 LA HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:PORT VINCENT
Mailing Address - State:LA
Mailing Address - Zip Code:70726-8051
Mailing Address - Country:US
Mailing Address - Phone:225-241-7335
Mailing Address - Fax:
Practice Address - Street 1:18750 LA HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:PORT VINCENT
Practice Address - State:LA
Practice Address - Zip Code:70726-8051
Practice Address - Country:US
Practice Address - Phone:225-241-7335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6208235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist