Provider Demographics
NPI:1275907230
Name:KELLEY, LASHAWNDRIA
Entity Type:Individual
Prefix:
First Name:LASHAWNDRIA
Middle Name:
Last Name:KELLEY
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 1:2439 MANHATTAN BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5342
Mailing Address - Country:US
Mailing Address - Phone:504-225-1202
Mailing Address - Fax:855-495-2118
Practice Address - Street 1:2439 MANHATTAN BLVD STE 211
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5342
Practice Address - Country:US
Practice Address - Phone:504-225-1202
Practice Address - Fax:855-495-2118
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-13
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator