Provider Demographics
NPI:1487362588
Name:HOGAN, LASHAUNTA MICHELLE (APC)
Entity type:Individual
Prefix:
First Name:LASHAUNTA
Middle Name:MICHELLE
Last Name:HOGAN
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 MCGINNIS FERRY RD APT 1720
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7224
Mailing Address - Country:US
Mailing Address - Phone:410-703-0265
Mailing Address - Fax:
Practice Address - Street 1:4025 MCGINNIS FERRY RD APT 1720
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7224
Practice Address - Country:US
Practice Address - Phone:410-703-0265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor