Provider Demographics
NPI:1558607754
Name:BRAUD, AMY E (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:AMY
Middle Name:E
Last Name:BRAUD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 ARMS STREET
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-7466
Mailing Address - Country:US
Mailing Address - Phone:985-228-3461
Mailing Address - Fax:
Practice Address - Street 1:1003 ARMS STREET
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-7466
Practice Address - Country:US
Practice Address - Phone:985-228-3461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2014-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6443235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist