Individual
DEREK DAIGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, PLPC
Contact information
Practice address
417 S JOHNSON ST, NEW ORLEANS, LA 70112-2237
(972) 391-4431
(504) 581-4702
Mailing address
417 S JOHNSON ST, NEW ORLEANS, LA 70112-2237
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6741
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
LA
Enumeration date
08/23/2016
Last updated
08/23/2016
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