Provider Demographics
NPI:1376849349
Name:LATIOLAIS, DANA D (CLP,NCPT,NCET)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:D
Last Name:LATIOLAIS
Suffix:
Gender:F
Credentials:CLP,NCPT,NCET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 BAYOU FUSELIER RD
Mailing Address - Street 2:
Mailing Address - City:ARNAUDVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70512-3005
Mailing Address - Country:US
Mailing Address - Phone:337-344-4277
Mailing Address - Fax:337-754-5240
Practice Address - Street 1:1271 BAYOU FUSELIER RD
Practice Address - Street 2:
Practice Address - City:ARNAUDVILLE
Practice Address - State:LA
Practice Address - Zip Code:70512-3005
Practice Address - Country:US
Practice Address - Phone:337-344-4277
Practice Address - Fax:337-754-5240
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACLP.201449-LAB246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy