Provider Demographics
NPI:1477901353
Name:POWELL, LAKYA
Entity Type:Individual
Prefix:
First Name:LAKYA
Middle Name:
Last Name:POWELL
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 1:2055 CANNAN ST
Mailing Address - Street 2:APT C
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-2059
Mailing Address - Country:US
Mailing Address - Phone:775-247-0358
Mailing Address - Fax:775-432-1706
Practice Address - Street 1:106 HUBBARD WAY
Practice Address - Street 2:STE E
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-432-1700
Practice Address - Fax:775-432-1706
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst