Provider Demographics
NPI:1447701107
Name:BABINEAUX, ERICKA (CO)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:BABINEAUX
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5335
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70606-5335
Mailing Address - Country:US
Mailing Address - Phone:337-502-7472
Mailing Address - Fax:
Practice Address - Street 1:314 W MCNEESE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5604
Practice Address - Country:US
Practice Address - Phone:337-502-7472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist