Provider Demographics
NPI:1073075305
Name:BOIHEM, DANA ELAINE
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ELAINE
Last Name:BOIHEM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 JOSHUA LOOP
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:LA
Mailing Address - Zip Code:70452-6359
Mailing Address - Country:US
Mailing Address - Phone:504-451-2866
Mailing Address - Fax:
Practice Address - Street 1:1505 N FLORIDA ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-1544
Practice Address - Country:US
Practice Address - Phone:985-900-1626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator