# JERICA CHUSTZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1356430672
- **Gender:** F
- **Credential:** AU

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 4787 | LA | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 12/12/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00125692 | — | MS |
| 05 | — | 1166812 | — | LA |