Healthcare Provider Details

I. General information

NPI: 1811344179
Provider Name (Legal Business Name): DANIELLE GRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7606 WESTBANK EXPY STE B
MARRERO LA
70072-2304
US

IV. Provider business mailing address

1209 N DORGENOIS ST
NEW ORLEANS LA
70119-3444
US

V. Phone/Fax

Practice location:
  • Phone: 504-265-0801
  • Fax: 504-265-8201
Mailing address:
  • Phone: 504-432-2474
  • 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: