Individual
SOTHEARY BRANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
708 HELEN ST, LAKE CHARLES, LA 70601-5713
(832) 693-0082
Mailing address
708 HELEN ST, LAKE CHARLES, LA 70601-5713
(832) 693-0082
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5975
LA
235Z00000X
Speech-Language Pathologist
S3394
MS
Other
Enumeration date
09/23/2009
Last updated
06/25/2020
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