Provider Demographics
NPI:1104070440
Name:LASHUA, KATHLEEN A (LMT, CRT, NMT, CMMP)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:A
Last Name:LASHUA
Suffix:
Gender:F
Credentials:LMT, CRT, NMT, CMMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21521
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34276-4521
Mailing Address - Country:US
Mailing Address - Phone:941-780-1654
Mailing Address - Fax:
Practice Address - Street 1:6981 CURTISS AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8100
Practice Address - Country:US
Practice Address - Phone:941-923-7248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA43233225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist