Healthcare Provider Details

I. General information

NPI: 1952800963
Provider Name (Legal Business Name): TIANA AUBREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S COLLEGE RD STE 180
LAFAYETTE LA
70503-3277
US

IV. Provider business mailing address

221 CRICKLADE CT
YOUNGSVILLE LA
70592-5433
US

V. Phone/Fax

Practice location:
  • Phone: 337-417-9897
  • Fax:
Mailing address:
  • Phone: 337-354-6377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: