Provider Demographics
NPI:1255799623
Name:LAGARDE, HANNAH ALEXIS
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ALEXIS
Last Name:LAGARDE
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 1:1455 WRIGHT AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-2220
Mailing Address - Country:US
Mailing Address - Phone:337-788-1480
Mailing Address - Fax:337-788-0354
Practice Address - Street 1:1455 WRIGHT AVE STE A
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2220
Practice Address - Country:US
Practice Address - Phone:337-788-1480
Practice Address - Fax:337-788-0354
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09246R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist