Provider Information for 1376772400
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
PORSCHE D LASTER LPC
Sex: Female
NPI: 1376772400
Last Updated: 2009-07-10
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1376772400 | ||||||||
| Enumeration Date | 2009-07-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3467 LEHIGH WAY DECATUR, GA 30034-5744 United States Phone: 678-327-3845 | Fax: | ||||||||
| Primary Practice Address | 120 E TRINITY PL DECATUR, GA 30030-3302 United States Phone: 404-378-2300 | Fax: | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|