Provider Demographics
NPI:1447544606
Name:STODDART, LASHAUNN (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:LASHAUNN
Middle Name:
Last Name:STODDART
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 CHATTAHOOCHEE RUN DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-8381
Mailing Address - Country:US
Mailing Address - Phone:404-723-8552
Mailing Address - Fax:
Practice Address - Street 1:1290 CHATTAHOOCHEE RUN DR
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-8381
Practice Address - Country:US
Practice Address - Phone:404-723-8552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002750225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist