Doctor Name: | MRS. BERNETTA AMBRES |
NPI Number: | 1740366327 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M. ED CCC-SLP |
License Number: | 4639 |
Business Practice Address: | 538 W 2nd St La Place, LA - 700686802 |
Business Phone Number: | 9856527233 |
Business Fax Number: | |
Mailing Address: | 128 Oak Moss Dr, LA PLACE |
State: | LA |
Postal Code: | 700687114 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4639 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |