Provider Demographics
NPI:1467523993
Name:CASH, LABRITA JEANENE
Entity Type:Individual
Prefix:
First Name:LABRITA
Middle Name:JEANENE
Last Name:CASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1259
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-1259
Mailing Address - Country:US
Mailing Address - Phone:770-317-5993
Mailing Address - Fax:770-720-2274
Practice Address - Street 1:1015 BRIDGE MILL AVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-7797
Practice Address - Country:US
Practice Address - Phone:770-317-5993
Practice Address - Fax:770-720-2274
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00953378EMedicaid