Provider Demographics
NPI:1235956046
Name:LAGARD, RAYNITA MARIE (BS)
Entity type:Individual
Prefix:
First Name:RAYNITA
Middle Name:MARIE
Last Name:LAGARD
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 POYDRAS ST APT 2511
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7588
Mailing Address - Country:US
Mailing Address - Phone:504-330-9931
Mailing Address - Fax:
Practice Address - Street 1:118 VILLAGE ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-5302
Practice Address - Country:US
Practice Address - Phone:504-330-9931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator