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Individual

DR. MELISSA ANNE DE LA O

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
2516 BROADMOOR BLVD # 1B, MONROE, LA 71201
(318) 812-1125
Mailing address
130 DESIARD ST STE 355, MONROE, LA 71201-7363
(318) 807-7875
(318) 812-6603

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
8159
LA
231H00000X
Audiologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2478877
LA
Enumeration date
05/25/2018
Last updated
06/11/2019
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