Provider Demographics
NPI:1588795082
Name:TRUAX, STACEY SCHNEIDER (MCD, SLP CF)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:SCHNEIDER
Last Name:TRUAX
Suffix:
Gender:F
Credentials:MCD, SLP CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 NEWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:LA
Mailing Address - Zip Code:70121-3316
Mailing Address - Country:US
Mailing Address - Phone:504-733-1776
Mailing Address - Fax:
Practice Address - Street 1:3000 W ESPLANADE AVE N
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1877
Practice Address - Country:US
Practice Address - Phone:504-885-1606
Practice Address - Fax:504-885-2603
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5671235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1584461Medicaid