Provider Demographics
NPI:1114787330
Name:VANSKIKE, LEONA DAVINA (RBT)
Entity Type:Individual
Prefix:
First Name:LEONA
Middle Name:DAVINA
Last Name:VANSKIKE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 SW A AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-3951
Mailing Address - Country:US
Mailing Address - Phone:580-353-8900
Mailing Address - Fax:
Practice Address - Street 1:1001 SW A AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3951
Practice Address - Country:US
Practice Address - Phone:580-353-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician