Provider Demographics
NPI:1225570062
Name:LINK, LAKESHA (MASTERS OF SCIENCE)
Entity Type:Individual
Prefix:
First Name:LAKESHA
Middle Name:
Last Name:LINK
Suffix:
Gender:F
Credentials:MASTERS OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 IRIS DR SW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-1245
Mailing Address - Country:US
Mailing Address - Phone:770-835-5151
Mailing Address - Fax:
Practice Address - Street 1:1936 IRIS DR SW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-1245
Practice Address - Country:US
Practice Address - Phone:770-835-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health