Healthcare Provider Details

I. General information

NPI: 1609296524
Provider Name (Legal Business Name): LASHAYLA HARRIS CRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 04/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CHARLOTTE DR
PATTERSON LA
70392-4146
US

IV. Provider business mailing address

410 CHARLOTTE DR
PATTERSON LA
70392-4146
US

V. Phone/Fax

Practice location:
  • Phone: 985-498-1576
  • Fax:
Mailing address:
  • Phone: 985-498-1576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberLRT.000522
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: