Healthcare Provider Details

I. General information

NPI: 1730961319
Provider Name (Legal Business Name): DEJA SAWYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7697 VINCENT ST
NEW ORLEANS LA
70128-3315
US

IV. Provider business mailing address

7697 VINCENT ST
NEW ORLEANS LA
70128-3315
US

V. Phone/Fax

Practice location:
  • Phone: 504-319-5982
  • Fax:
Mailing address:
  • Phone: 504-319-5982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLA9816
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: