Individual
DANEISHA Q BUCKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
837 DECATUR ST, PONCHATOULA, LA 70454-9715
(504) 236-5114
Mailing address
837 DECATUR ST, PONCHATOULA, LA 70454-9715
(504) 236-5114
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/01/2024
Last updated
12/09/2024
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