Provider Demographics
NPI:1447608377
Name:LASSETER, ALANNA
Entity type:Individual
Prefix:
First Name:ALANNA
Middle Name:
Last Name:LASSETER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 DANES CT
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-2763
Mailing Address - Country:US
Mailing Address - Phone:863-602-1760
Mailing Address - Fax:
Practice Address - Street 1:5010 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2510
Practice Address - Country:US
Practice Address - Phone:863-644-2411
Practice Address - Fax:863-582-9251
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW179211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical