Healthcare Provider Details

I. General information

NPI: 1902357700
Provider Name (Legal Business Name): ANDREA LASHLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 BECKETT LN
MORRIS AL
35116-0140
US

IV. Provider business mailing address

620 BECKETT LN
MORRIS AL
35116-0140
US

V. Phone/Fax

Practice location:
  • Phone: 205-937-7320
  • Fax:
Mailing address:
  • Phone: 205-937-7320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC2369A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: