Provider Demographics
NPI:1851813646
Name:LLOYD, KEILA ELIZABETH
Entity Type:Individual
Prefix:
First Name:KEILA
Middle Name:ELIZABETH
Last Name:LLOYD
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 1:3200 SOUTHSIDE RD
Mailing Address - Street 2:
Mailing Address - City:SUTHERLIN
Mailing Address - State:OR
Mailing Address - Zip Code:97479-9734
Mailing Address - Country:US
Mailing Address - Phone:541-815-3194
Mailing Address - Fax:
Practice Address - Street 1:770 SE KANE ST
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-3943
Practice Address - Country:US
Practice Address - Phone:541-464-6455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor