Provider Demographics
NPI:1548949100
Name:STAMPLEY, TA'LARRA
Entity type:Individual
Prefix:MISS
First Name:TA'LARRA
Middle Name:
Last Name:STAMPLEY
Suffix:
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 1:115 LYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-2010
Mailing Address - Country:US
Mailing Address - Phone:318-301-9292
Mailing Address - Fax:318-336-4777
Practice Address - Street 1:1109 CARTER ST STE 10
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3227
Practice Address - Country:US
Practice Address - Phone:318-336-4700
Practice Address - Fax:318-336-4777
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator