Provider Demographics
NPI:1558748814
Name:LAMBERT, SASHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SASHA
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:SASHA
Other - Middle Name:LAMBERT
Other - Last Name:FOGLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:201 SETTLERS TRACE BLVD
Mailing Address - Street 2:#4411
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6781
Mailing Address - Country:US
Mailing Address - Phone:337-852-9189
Mailing Address - Fax:
Practice Address - Street 1:119 CAILLOUETT PL
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-7807
Practice Address - Country:US
Practice Address - Phone:337-234-4912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1227103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical