Provider Demographics
NPI:1255137071
Name:TEZENO, SCLANDA
Entity type:Individual
Prefix:
First Name:SCLANDA
Middle Name:
Last Name:TEZENO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1562 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-2824
Mailing Address - Country:US
Mailing Address - Phone:337-831-8171
Mailing Address - Fax:
Practice Address - Street 1:4001 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-4634
Practice Address - Country:US
Practice Address - Phone:337-831-8171
Practice Address - Fax:337-363-8527
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care