Provider Demographics
NPI:1396333555
Name:DAIGLE, SUNNY STEIN
Entity type:Individual
Prefix:
First Name:SUNNY
Middle Name:STEIN
Last Name:DAIGLE
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 1:813 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3818
Mailing Address - Country:US
Mailing Address - Phone:225-964-6515
Mailing Address - Fax:
Practice Address - Street 1:813 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-3818
Practice Address - Country:US
Practice Address - Phone:225-964-6515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4557235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist