Individual
NICOLE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8414 BLUEBONNET BLVD, SUITE 210, BATON ROUGE, LA 70810-2840
(225) 302-1513
Mailing address
5909 CONGRESS BLVD, BATON ROUGE, LA 70808-3322
(225) 302-1513
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LA # 4643-01
LA
Other
Enumeration date
05/06/2010
Last updated
05/06/2010
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