Provider Demographics
NPI:1548386105
Name:LASLIE, ESTRAYA
Entity Type:Individual
Prefix:MRS
First Name:ESTRAYA
Middle Name:
Last Name:LASLIE
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 1:5115 DOUBLETREE DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-9427
Mailing Address - Country:US
Mailing Address - Phone:678-455-7444
Mailing Address - Fax:678-455-7444
Practice Address - Street 1:5115 DOUBLETREE DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-9427
Practice Address - Country:US
Practice Address - Phone:678-455-7444
Practice Address - Fax:678-455-7444
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator