Individual
LAURIE LEBLANC DAIGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7777 HENNESSY BLVD, SUITE #211, BATON ROUGE, LA 70808-4300
(225) 765-7163
Mailing address
DEPT AT 952639, ATLANTA, GA 31192-2639
(877) 485-4474
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.719.EXAM
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2121642
—
LA
Enumeration date
06/14/2010
Last updated
10/26/2010
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