Provider Demographics
NPI:1194697409
Name:PATTERSON, LASHAYNA D (LPTA)
Entity type:Individual
Prefix:
First Name:LASHAYNA
Middle Name:D
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 NURSING HOME RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31057-3715
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:777 NURSING HOME RD
Practice Address - Street 2:
Practice Address - City:MARSHALLVILLE
Practice Address - State:GA
Practice Address - Zip Code:31057-3715
Practice Address - Country:US
Practice Address - Phone:478-967-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA005137225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant