Provider Demographics
NPI:1356879233
Name:BARR, LASHAWNDA
Entity type:Individual
Prefix:
First Name:LASHAWNDA
Middle Name:
Last Name:BARR
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 1:1070 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-7547
Mailing Address - Country:US
Mailing Address - Phone:312-856-6626
Mailing Address - Fax:
Practice Address - Street 1:1070 W 14TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-7547
Practice Address - Country:US
Practice Address - Phone:312-856-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency