Provider Demographics
NPI:1518587534
Name:SHAHEEN, EMMALEE (ND)
Entity Type:Individual
Prefix:
First Name:EMMALEE
Middle Name:
Last Name:SHAHEEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 APRIL DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70611-3928
Mailing Address - Country:US
Mailing Address - Phone:337-513-2418
Mailing Address - Fax:
Practice Address - Street 1:3819 RYAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-2815
Practice Address - Country:US
Practice Address - Phone:337-602-8405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20-1869175F00000X
LA326922171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath