Healthcare Provider Details

I. General information

NPI: 1679688279
Provider Name (Legal Business Name): DAISY HEUMANN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 METAIRIE RD SUITE 201
METAIRIE LA
70005-4300
US

IV. Provider business mailing address

315 METAIRIE RD SUITE 201
METAIRIE LA
70005-4300
US

V. Phone/Fax

Practice location:
  • Phone: 504-837-1107
  • Fax: 985-871-9058
Mailing address:
  • Phone: 504-837-1107
  • Fax: 985-871-9058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3491
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: