Individual
LASHONDA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
809 POLK ST, MANSFIELD, LA 71052
(318) 871-5566
Mailing address
809 POLK ST, MANSFIELD, LA 71052-2452
(318) 871-5566
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72-1410474
—
LA
Enumeration date
03/23/2017
Last updated
07/15/2018
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