Healthcare Provider Details

I. General information

NPI: 1972423051
Provider Name (Legal Business Name): SUNNY D HATTAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 N NEW HAMPSHIRE ST
COVINGTON LA
70433-2829
US

IV. Provider business mailing address

413 N NEW HAMPSHIRE ST
COVINGTON LA
70433-2829
US

V. Phone/Fax

Practice location:
  • Phone: 504-388-1915
  • Fax:
Mailing address:
  • Phone: 504-388-1915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number10266
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: