Provider Demographics
NPI:1619864675
Name:RABY, LATASHA RENA
Entity type:Individual
Prefix:
First Name:LATASHA
Middle Name:RENA
Last Name:RABY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LATASHA
Other - Middle Name:RABY
Other - Last Name:STELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13295 FOWLER DR
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-3443
Mailing Address - Country:US
Mailing Address - Phone:225-316-8468
Mailing Address - Fax:
Practice Address - Street 1:13295 FOWLER DR
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-3443
Practice Address - Country:US
Practice Address - Phone:225-316-8468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health