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General NPI Number Information
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NPI Number | 1548621188
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Entity Type | Individual
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Provider Name | TAINA COMERY
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Gender | Female
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Dates
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Enumeration Date | 03/10/2016
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 206 CLINIC DR
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City | DONALDSONVILLE
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State | LA
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Zip | 70346-4309
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Country | US
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Telephone | 225-264-6670
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Fax |
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Provider Business Mailing Address
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Address Line | 15499 TIMBERSTONE DR
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City | PRAIRIEVILLE
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State | LA
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Zip | 70769-6287
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Country | US
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Telephone | 225-323-1995
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 13456
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License Number State | LA
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