Provider Demographics
NPI:1639520398
Name:LANDRY, LITONIA
Entity Type:Individual
Prefix:MS
First Name:LITONIA
Middle Name:
Last Name:LANDRY
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 1:1215 INDEPENDENCE BLVD STE 2A
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-7391
Mailing Address - Country:US
Mailing Address - Phone:225-306-4488
Mailing Address - Fax:225-306-4390
Practice Address - Street 1:1215 INDEPENDENCE BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-7391
Practice Address - Country:US
Practice Address - Phone:225-306-4488
Practice Address - Fax:225-306-4390
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator