Provider Demographics
NPI:1841096575
Name:CONNELLY, RESHELLE LACASSE (NBHWC)
Entity type:Individual
Prefix:MRS
First Name:RESHELLE
Middle Name:LACASSE
Last Name:CONNELLY
Suffix:
Gender:F
Credentials:NBHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 E 600 S
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:IN
Mailing Address - Zip Code:46031-9347
Mailing Address - Country:US
Mailing Address - Phone:703-819-0962
Mailing Address - Fax:
Practice Address - Street 1:96 E 600 S
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:IN
Practice Address - Zip Code:46031-9347
Practice Address - Country:US
Practice Address - Phone:703-819-0962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach