Basic Information
| Provider Information | |||||||||
| NPI: | 1396316584 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAIGLE | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | |||||||||
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| Credential: | PLPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 109 S CATE ST APT B | ||||||||
| Address2: | |||||||||
| City: | HAMMOND | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704034299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372549443 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1505 N FLORIDA ST | ||||||||
| Address2: | |||||||||
| City: | COVINGTON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704331544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9857816080 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2021 | ||||||||
| LastUpdateDate: | 07/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | PLC8642 | LA | N | Behavioral Health & Social Service Providers | Counselor | 171M00000X | PLC8642 | LA | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.