Provider Demographics
NPI:1417376047
Name:MOTURU LALITHA KUMARI
Entity Type:Organization
Organization Name:MOTURU LALITHA KUMARI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BARRINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-769-1103
Mailing Address - Street 1:4983 BLUEBONNET BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3094
Mailing Address - Country:US
Mailing Address - Phone:225-169-1103
Mailing Address - Fax:225-761-5155
Practice Address - Street 1:4983 BLUEBONNET BLVD STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3094
Practice Address - Country:US
Practice Address - Phone:225-169-1103
Practice Address - Fax:225-761-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LABK3590002103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Multi-Specialty