Provider Demographics
NPI:1437643665
Name:WASHINGTON, SHALA DENISE (MA)
Entity Type:Individual
Prefix:MRS
First Name:SHALA
Middle Name:DENISE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:SHALA
Other - Middle Name:DENISE
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:9150 BEREFORD DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9150 BEREFORD DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2403
Practice Address - Country:US
Practice Address - Phone:225-960-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician