1841561966 NPI number — MS. LORITA LYNETTE SLAUGHTER BCBA

Table of content: MS. LORITA LYNETTE SLAUGHTER BCBA (NPI 1841561966)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841561966 NPI number — MS. LORITA LYNETTE SLAUGHTER BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SLAUGHTER
Provider First Name:
LORITA
Provider Middle Name:
LYNETTE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
BCBA
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:
1841561966
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
352 HOFFPAUIR RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAGLEY
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70657-6233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-515-2994
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
855 SHIRLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUNKIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71322-1540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-346-9288
Provider Business Practice Location Address Fax Number:
318-346-9269
Provider Enumeration Date:
01/20/2012

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: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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