Provider Demographics
NPI:1861855447
Name:EDMONDS, LAKOYA (MS)
Entity Type:Individual
Prefix:MRS
First Name:LAKOYA
Middle Name:
Last Name:EDMONDS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:AL
Mailing Address - Zip Code:36401-3156
Mailing Address - Country:US
Mailing Address - Phone:251-238-4631
Mailing Address - Fax:
Practice Address - Street 1:220 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:AL
Practice Address - Zip Code:36401-3156
Practice Address - Country:US
Practice Address - Phone:251-238-4631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health