Provider Demographics
NPI:1104361112
Name:LEMOINE, ABBY
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:LEMOINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 INDEPENDENCE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3566
Mailing Address - Country:US
Mailing Address - Phone:318-542-4288
Mailing Address - Fax:318-300-1233
Practice Address - Street 1:3921 INDEPENDENCE DR STE 104
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303
Practice Address - Country:US
Practice Address - Phone:318-542-4288
Practice Address - Fax:318-300-1233
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator