Provider Demographics
NPI:1174017479
Name:MURCHISON, LAKECIA
Entity Type:Individual
Prefix:
First Name:LAKECIA
Middle Name:
Last Name:MURCHISON
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 1:6900 HIGHVIEW TER APT 301
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-4013
Mailing Address - Country:US
Mailing Address - Phone:919-630-9085
Mailing Address - Fax:
Practice Address - Street 1:6900 HIGHVIEW TER APT 301
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-4013
Practice Address - Country:US
Practice Address - Phone:919-630-9085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst