Mitzi R. Brunet, MS,CCC,SLP
Individual provider Active NPI Speech-Language Pathologist · Galliano, LA
NPI 1750414546 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1750414546
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 3439 (LA)
- Practice address
- 106 West 164 Street
Galliano, LA 70354 - Phone
- (985) 632-4763
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- 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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3439 | LA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3439 | LA | Yes |
Addresses
Primary practice location
106 West 164 Street
Galliano, LA 70354
Mailing address
PO Box 466
Cut Off, LA 70345-0466
Phone (985) 632-4763
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1472352 | Medicaid | LA |
Other providers in Galliano, LA
- Jessica Thiac Aucoin
- Diane Marie Badeaux
- John Ray Bilello
- Simone Bishop
- Roger James Blanchard Jr.
- Chase Michael Cheramie
- Kaylee Michelle Cole
- Ron Dantin
- Department of Health and Hospitals
- Dr Elliott Apcc
All providers in Galliano, 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 Jul 8, 2007. 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.