Provider Demographics
NPI:1780373696
Name:MILLER, LASHAWNA
Entity type:Individual
Prefix:
First Name:LASHAWNA
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LASHAWNA
Other - Middle Name:
Other - Last Name:OUBRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18584 PERKINS OAK RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3757
Mailing Address - Country:US
Mailing Address - Phone:225-398-2702
Mailing Address - Fax:
Practice Address - Street 1:14635 S HARRELLS FERRY RD STE 3A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2960
Practice Address - Country:US
Practice Address - Phone:225-349-8984
Practice Address - Fax:844-269-9818
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health