Provider Demographics
NPI:1447328695
Name:LANZILLOTTI, DAVID ANTHONY (MA LPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANTHONY
Last Name:LANZILLOTTI
Suffix:
Gender:M
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2285 BENTON RD BLDG 3
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-7933
Mailing Address - Country:US
Mailing Address - Phone:318-747-1171
Mailing Address - Fax:318-741-0522
Practice Address - Street 1:2285 BENTON RD BLDG 3
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-7933
Practice Address - Country:US
Practice Address - Phone:318-747-1171
Practice Address - Fax:318-741-0522
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health