1780834986 NPI number — MRS. PATTI GENNARDO LANIER LCSW

Table of content: DR. LOI T NGUYEN D.M.D (NPI 1942514088)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780834986 NPI number — MRS. PATTI GENNARDO LANIER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANIER
Provider First Name:
PATTI
Provider Middle Name:
GENNARDO
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780834986
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47285 RUFUS BANKSTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TICKFAW
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70466-4503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-507-1368
Provider Business Mailing Address Fax Number:
985-345-1157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
47285 RUFUS BANKSTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TICKFAW
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70466-4503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-507-1368
Provider Business Practice Location Address Fax Number:
985-345-1157
Provider Enumeration Date:
09/24/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  3729 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com