Provider Demographics
NPI:1497527600
Name:HAVARD, HALI (CPHT)
Entity Type:Individual
Prefix:
First Name:HALI
Middle Name:
Last Name:HAVARD
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 BELL LN STE 5A
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-6303
Mailing Address - Country:US
Mailing Address - Phone:318-998-3018
Mailing Address - Fax:318-998-3020
Practice Address - Street 1:222 BELL LN STE 5A
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-6303
Practice Address - Country:US
Practice Address - Phone:318-998-3018
Practice Address - Fax:318-998-3020
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACPT.016658183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician