Provider Demographics
NPI:1528418514
Name:REED, LAQUONDA (MA)
Entity Type:Individual
Prefix:
First Name:LAQUONDA
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 MERGANSER ST # B
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70615-6898
Mailing Address - Country:US
Mailing Address - Phone:337-433-1062
Mailing Address - Fax:337-439-1094
Practice Address - Street 1:2400 MERGANSER ST # B
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70615-6898
Practice Address - Country:US
Practice Address - Phone:337-433-1062
Practice Address - Fax:337-439-1094
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health