Individual
HAILEY MARIE DETILLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
465 BELLE TERRE BLVD, LA PLACE, LA 70068-2437
(985) 623-2200
(985) 625-2206
Mailing address
PO BOX 1125, GRAMERCY, LA 70052-1125
(225) 348-7120
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
343494
LA
Other
Enumeration date
08/08/2024
Last updated
09/03/2025
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