Provider Demographics
NPI:1962888255
Name:HASBERRY, ALICE X
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:HASBERRY
Suffix:X
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 1:6900 LAKE KENILWORTH DRIVE Q 226
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126
Mailing Address - Country:US
Mailing Address - Phone:504-908-9076
Mailing Address - Fax:504-304-7697
Practice Address - Street 1:6900 LAKE KENILWORTH DR # Q226
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-2974
Practice Address - Country:US
Practice Address - Phone:504-908-9076
Practice Address - Fax:504-304-7697
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health