Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1063042646 |
---|---|
Provider Name | Lakisha Metcalf |
First Address | North Las Vegas, NV 89086-1435 |
Second Address | North Las Vegas, NV 89086-1435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2020 |
Last Update Date | 22/01/2020 |