Provider Demographics
NPI:1326764168
Name:WASHINGTON, LASHONDA DENISE (INDEPENDENT PROVIDER)
Entity Type:Individual
Prefix:PROF
First Name:LASHONDA
Middle Name:DENISE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5247 FOREST AVENUE APT UP
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137
Mailing Address - Country:US
Mailing Address - Phone:216-303-3588
Mailing Address - Fax:
Practice Address - Street 1:5247 FOREST AVE APT UP
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-1046
Practice Address - Country:US
Practice Address - Phone:216-303-3588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty