Provider Demographics
NPI:1821365313
Name:MCDADE, LASHONDA (MS)
Entity Type:Individual
Prefix:MS
First Name:LASHONDA
Middle Name:
Last Name:MCDADE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WEST FAIRVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27855-9367
Mailing Address - Country:US
Mailing Address - Phone:980-395-6062
Mailing Address - Fax:
Practice Address - Street 1:108 W FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:NC
Practice Address - Zip Code:27855-9367
Practice Address - Country:US
Practice Address - Phone:980-395-6062
Practice Address - Fax:866-891-2574
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist