Provider Demographics
NPI:1619133527
Name:MCELRATH, LA-TEESHA
Entity Type:Individual
Prefix:MISS
First Name:LA-TEESHA
Middle Name:
Last Name:MCELRATH
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 1:699 HERTEL AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-2341
Mailing Address - Country:US
Mailing Address - Phone:716-834-0282
Mailing Address - Fax:
Practice Address - Street 1:699 HERTEL AVE STE 330
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-2341
Practice Address - Country:US
Practice Address - Phone:716-834-0282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health