Ghanta, Supriya

Ghanta, Supriya is an sole proprietor health care provider with primary practice located at 103 Belview Rd , Leesville LA 71446-2902. She recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as her primary health care specialty. Ghanta, Supriya can be contacted via phone (337) 238-6431.

Contact Information

Primary practice address
103 Belview Rd Leesville LA 71446-2902
Phone: (337) 238-6431
Fax: (337) 238-7070
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X L05605R Louisiana

Profile Details

NPI number 1669550521
LBN Legal business name Ghanta, Supriya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Nov 5th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669550521 NPPES
Louisiana MEDICAID 1328006
Louisiana Other L05605R

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