Provider Demographics
NPI:1629195854
Name:LASH, LOUISE PROPST (COTAL)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:PROPST
Last Name:LASH
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WORTHDALE DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5329
Mailing Address - Country:US
Mailing Address - Phone:336-768-2211
Mailing Address - Fax:336-659-0783
Practice Address - Street 1:105 WORTHDALE DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5329
Practice Address - Country:US
Practice Address - Phone:336-768-2211
Practice Address - Fax:336-659-0783
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1647224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant