Provider Demographics
NPI:1316698608
Name:SAXON, DANIELLE RAYE (IBCLC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RAYE
Last Name:SAXON
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37244 SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3320
Mailing Address - Country:US
Mailing Address - Phone:601-493-6599
Mailing Address - Fax:
Practice Address - Street 1:37244 SWAMP RD
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3320
Practice Address - Country:US
Practice Address - Phone:601-493-6599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN147938163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant