Healthcare Provider Details

I. General information

NPI: 1386570570
Provider Name (Legal Business Name): TAWANNA HART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 W MORRIS AVE STE E
HAMMOND LA
70403-3854
US

IV. Provider business mailing address

35845 BILL STILLEY RD
INDEPENDENCE LA
70443-3621
US

V. Phone/Fax

Practice location:
  • Phone: 985-662-3799
  • Fax: 985-662-3829
Mailing address:
  • Phone: 985-687-5811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: