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General NPI Number Information
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NPI Number | 1053880427
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Entity Type | Individual
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Provider Name | LASONDRA MCDOWELL
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Gender | Female
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Dates
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Enumeration Date | 11/15/2018
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Last Update Date | 05/30/2019
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Provider Practice Location Address
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Address Line | 6520 BASELINE RD
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City | LITTLE ROCK
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State | AR
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Zip | 72209-4732
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Country | US
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Telephone | 501-541-5924
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Fax |
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Provider Business Mailing Address
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Address Line | 3969 EASTERN SLOPE DR
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City | ALEXANDER
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State | AR
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Zip | 72002-1773
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Country | US
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Telephone | 501-541-5924
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | AR5555
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | AR5555
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 186
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License Number State | AR
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