Healthcare Provider Details

I. General information

NPI: 1093647901
Provider Name (Legal Business Name): MAGNOLIA NATUROPATHIC WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 MLK DR
JEANERETTE LA
70544-5123
US

IV. Provider business mailing address

1435 MLK DR
JEANERETTE LA
70544-5123
US

V. Phone/Fax

Practice location:
  • Phone: 337-552-3642
  • Fax:
Mailing address:
  • Phone: 337-552-3642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: TICHINA ARNOLD
Title or Position: PHYSICIAN
Credential: ND
Phone: 337-552-3642