Provider Demographics
NPI:1689023772
Name:HERRING, ELENA GENEE'
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:GENEE'
Last Name:HERRING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:GENEE'
Other - Last Name:HERRING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1932 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-5825
Mailing Address - Country:US
Mailing Address - Phone:225-888-4868
Mailing Address - Fax:
Practice Address - Street 1:1932 74TH AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807-5825
Practice Address - Country:US
Practice Address - Phone:225-888-4868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist