Provider Demographics
NPI:1790700540
Name:DOUCET, DANIEL L (MS,ATC, LAT,LCEP)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:L
Last Name:DOUCET
Suffix:
Gender:M
Credentials:MS,ATC, LAT,LCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 MONTEIGNE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-5424
Mailing Address - Country:US
Mailing Address - Phone:337-277-1782
Mailing Address - Fax:337-374-4391
Practice Address - Street 1:600 N LEWIS ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2043
Practice Address - Country:US
Practice Address - Phone:377-277-1782
Practice Address - Fax:337-374-4391
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAJOOO142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer