Provider Demographics
NPI:1457017147
Name:ELAASAR, RIFAT (MA)
Entity Type:Individual
Prefix:MRS
First Name:RIFAT
Middle Name:
Last Name:ELAASAR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:RIFAT
Other - Middle Name:AHMED
Other - Last Name:JOONAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2 CHATEAU PONTET CANET DR
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2036
Mailing Address - Country:US
Mailing Address - Phone:504-756-2756
Mailing Address - Fax:
Practice Address - Street 1:4600 RIVER RD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-1943
Practice Address - Country:US
Practice Address - Phone:504-349-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1701033Medicaid