Basic Information
Provider Information
NPI: 1942298716
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOBBS
FirstName: BRENDA
MiddleName: C.
NamePrefix:  
NameSuffix:  
Credential: CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 134 HOSPITAL DR
Address2: SUITE 109
City: LAFAYETTE
State: LA
PostalCode: 705032819
CountryCode: US
TelephoneNumber: 3372615151
FaxNumber:  
Practice Location
Address1: 134 HOSPITAL DR
Address2: SUITE 109
City: LAFAYETTE
State: LA
PostalCode: 705032819
CountryCode: US
TelephoneNumber: 3372615151
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/06/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X1856LAY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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