Jarvis Tramon Bright
Individual provider Active NPI Speech-Language Pathologist · Prairieville, LA
NPI 1245965631 · NPPES record last updated Apr 18, 2024
Key facts
- NPI
- 1245965631
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2202011308 (VA)
- Practice address
- 16366 Beech St
Prairieville, LA 70769-5900 - Phone
- (504) 512-8697
- NPI assigned
- Jul 19, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7758 | LA | MD | Speech-Language Pathologist |
| 2202011308 | VA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7758 | LA | |
| Speech-Language Pathologist | 235Z00000X | 2202011308 | VA | Yes |
Addresses
Primary practice location
16366 Beech St
Prairieville, LA 70769-5900
Mailing address
16366 Beech St
Prairieville, LA 70769-5900
Phone (504) 512-8697
Other providers in Prairieville, LA
- Keuna Bradford
- Patricia Gayle Bradford
- Silvia Brautigam-Martinez
- Patricia Minnis Brazier-Carter
- Amanda Breaux
- Jordan Brignac
- Angie Bringaze
- Allyson Britton
- Arielle Alicia Brown
- David Christopher Brown
All providers in Prairieville, LA · Speech-Language Pathologist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.