Provider Demographics
NPI:1033255294
Name:HAMBRICK, LA DONNA RHNEE (GSW)
Entity Type:Individual
Prefix:MS
First Name:LA DONNA
Middle Name:RHNEE
Last Name:HAMBRICK
Suffix:
Gender:F
Credentials:GSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 CEDER STREET
Mailing Address - Street 2:POB 124
Mailing Address - City:GIBSLAND
Mailing Address - State:LA
Mailing Address - Zip Code:71028-0124
Mailing Address - Country:US
Mailing Address - Phone:318-676-5135
Mailing Address - Fax:318-676-5137
Practice Address - Street 1:1310 N HEARNE AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-6516
Practice Address - Country:US
Practice Address - Phone:318-676-5135
Practice Address - Fax:318-676-5137
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6571104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker