Provider Demographics
NPI:1356911267
Name:BOLLAT, LINDSEY ROCHELLE
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ROCHELLE
Last Name:BOLLAT
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 1:3717 E LOUISIANA STATE DR
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2505
Mailing Address - Country:US
Mailing Address - Phone:504-645-9942
Mailing Address - Fax:
Practice Address - Street 1:3717 E LOUISIANA STATE DR
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2505
Practice Address - Country:US
Practice Address - Phone:504-645-9942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty