Individual
KIM DAIGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 W 2ND ST, THIBODAUX, LA 70301-3004
(985) 446-5244
Mailing address
102 W 2ND ST, THIBODAUX, LA 70301-3004
(985) 446-5244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/15/2015
Last updated
04/05/2016
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