Provider Demographics
NPI:1164808242
Name:LASH, SASHA
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:LASH
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 1:9285 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:EAST JORDAN
Mailing Address - State:MI
Mailing Address - Zip Code:49727-9311
Mailing Address - Country:US
Mailing Address - Phone:231-342-8886
Mailing Address - Fax:
Practice Address - Street 1:9285 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:EAST JORDAN
Practice Address - State:MI
Practice Address - Zip Code:49727-9311
Practice Address - Country:US
Practice Address - Phone:231-342-8886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist