Provider Demographics
NPI:1255835278
Name:HINSON, LALIA (CPHT)
Entity Type:Individual
Prefix:
First Name:LALIA
Middle Name:
Last Name:HINSON
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01022-1063
Mailing Address - Country:US
Mailing Address - Phone:609-947-5307
Mailing Address - Fax:
Practice Address - Street 1:1616 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3933
Practice Address - Country:US
Practice Address - Phone:413-532-3299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA30066476OtherCPHT