Healthcare Provider Details

I. General information

NPI: 1295393494
Provider Name (Legal Business Name): LAQUITA M SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11408 LAKE SHERWOOD AVE N STE A
BATON ROUGE LA
70816-0421
US

IV. Provider business mailing address

3338 SYCAMORE ST
BATON ROUGE LA
70805-3468
US

V. Phone/Fax

Practice location:
  • Phone: 225-261-7143
  • Fax: 225-250-1026
Mailing address:
  • Phone: 225-316-5538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: