Provider Demographics
NPI:1023361078
Name:LOVELADY, REBECCA LANELL
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LANELL
Last Name:LOVELADY
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 1:8984 SALVATORE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4943
Mailing Address - Country:US
Mailing Address - Phone:541-390-2501
Mailing Address - Fax:
Practice Address - Street 1:8984 SALVATORE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4943
Practice Address - Country:US
Practice Address - Phone:541-390-2501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health