Provider Demographics
NPI:1871803239
Name:LASHLEY, DORA ORENA
Entity type:Individual
Prefix:
First Name:DORA
Middle Name:ORENA
Last Name:LASHLEY
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 1:503 N DESLOGE DR
Mailing Address - Street 2:
Mailing Address - City:DESLOGE
Mailing Address - State:MO
Mailing Address - Zip Code:63601-3223
Mailing Address - Country:US
Mailing Address - Phone:573-518-0333
Mailing Address - Fax:573-518-0333
Practice Address - Street 1:503 N DESLOGE DR
Practice Address - Street 2:
Practice Address - City:DESLOGE
Practice Address - State:MO
Practice Address - Zip Code:63601-3223
Practice Address - Country:US
Practice Address - Phone:573-518-0333
Practice Address - Fax:573-518-0333
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC1052915251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health