Provider Demographics
NPI:1972013324
Name:CRITTON, LABREESHYA
Entity Type:Individual
Prefix:
First Name:LABREESHYA
Middle Name:
Last Name:CRITTON
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 1:6907 HWY 165 SOUTH
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71415
Mailing Address - Country:US
Mailing Address - Phone:318-340-1535
Mailing Address - Fax:
Practice Address - Street 1:6907 HWY 165 SOUTH
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71415
Practice Address - Country:US
Practice Address - Phone:318-649-6399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator