Provider Demographics
NPI:1427255017
Name:RAYMOND, CHRISTIE MICHELLE (DROT, LOTR)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:MICHELLE
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:DROT, LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 PARKLANE DR.
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111
Mailing Address - Country:US
Mailing Address - Phone:318-393-2191
Mailing Address - Fax:318-747-9257
Practice Address - Street 1:207 PARKLANE DR.
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111
Practice Address - Country:US
Practice Address - Phone:318-393-2191
Practice Address - Fax:318-747-9257
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ12014174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist