Healthcare Provider Details

I. General information

NPI: 1245185362
Provider Name (Legal Business Name): JEANNE RICHARD DANIEL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1160 HOSPITAL RD STE 100
NEW ROADS LA
70760-2633
US

IV. Provider business mailing address

1160 HOSPITAL RD STE 100
NEW ROADS LA
70760-2633
US

V. Phone/Fax

Practice location:
  • Phone: 225-638-4455
  • Fax: 225-208-6173
Mailing address:
  • Phone: 225-638-4455
  • Fax: 225-208-6173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number005424989
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: