Provider Demographics
NPI:1699193433
Name:EVANS, LUKITHIA YUNITA
Entity Type:Individual
Prefix:
First Name:LUKITHIA
Middle Name:YUNITA
Last Name:EVANS
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 1:4089 STUDIO ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-2313
Mailing Address - Country:US
Mailing Address - Phone:702-826-8061
Mailing Address - Fax:
Practice Address - Street 1:4089 STUDIO ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-2313
Practice Address - Country:US
Practice Address - Phone:702-826-8061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-30
Last Update Date:2014-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor