Provider Demographics
NPI:1215186697
Name:GAUTHIER, ALISHA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALISHA
Middle Name:MARIE
Last Name:GAUTHIER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9890 LAKE FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-2607
Mailing Address - Country:US
Mailing Address - Phone:832-215-8821
Mailing Address - Fax:
Practice Address - Street 1:9890 LAKE FOREST BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-2607
Practice Address - Country:US
Practice Address - Phone:832-215-8821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17256183500000X
LA43808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist