Provider Demographics
NPI:1972056950
Name:HARPER, LAKEESHA
Entity Type:Individual
Prefix:
First Name:LAKEESHA
Middle Name:
Last Name:HARPER
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 1:420 AUTUMN VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-7583
Mailing Address - Country:US
Mailing Address - Phone:216-526-7228
Mailing Address - Fax:
Practice Address - Street 1:420 AUTUMN VILLAGE CT
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-7583
Practice Address - Country:US
Practice Address - Phone:216-526-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health