Provider Demographics
NPI:1376125955
Name:MANNING, LASHONDA (PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:LASHONDA
Middle Name:
Last Name:MANNING
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 RAVENNA DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-1054
Mailing Address - Country:US
Mailing Address - Phone:586-522-6836
Mailing Address - Fax:
Practice Address - Street 1:3314 RAVENNA DR
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-1054
Practice Address - Country:US
Practice Address - Phone:586-522-6836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy