Provider Demographics
NPI:1841797123
Name:PERRODIN, CHASITY
Entity Type:Individual
Prefix:
First Name:CHASITY
Middle Name:
Last Name:PERRODIN
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 1:101 MICHAEL ALLEN BLVD APT 4B
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-7649
Mailing Address - Country:US
Mailing Address - Phone:337-349-9460
Mailing Address - Fax:
Practice Address - Street 1:101 MICHAEL ALLEN BLVD APT 4B
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-7649
Practice Address - Country:US
Practice Address - Phone:337-349-9460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator