Healthcare Provider Details

I. General information

NPI: 1871423764
Provider Name (Legal Business Name): TUNEEKA SHANDALE AYANNA DANIELS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 W TUNNEL BLVD
HOUMA LA
70360-2801
US

IV. Provider business mailing address

313 JOHN EDWARD LN
THIBODAUX LA
70301-7477
US

V. Phone/Fax

Practice location:
  • Phone: 985-709-0071
  • Fax: 985-709-0029
Mailing address:
  • Phone: 225-933-4839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: