Provider Demographics
NPI:1780329318
Name:ANDERSON, CA'CHEREAL LAQUET
Entity type:Individual
Prefix:MISS
First Name:CA'CHEREAL
Middle Name:LAQUET
Last Name:ANDERSON
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 1:320 E WINTERGREEN RD APT 21J
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2475
Mailing Address - Country:US
Mailing Address - Phone:214-957-2276
Mailing Address - Fax:
Practice Address - Street 1:404 COUNTRY RIDGE LN
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-3993
Practice Address - Country:US
Practice Address - Phone:214-957-2276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health