Provider Demographics
NPI:1396444774
Name:HARRIS, LAKEISHA MONEIK
Entity type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:MONEIK
Last Name:HARRIS
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 1:13935 COYLE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-2534
Mailing Address - Country:US
Mailing Address - Phone:248-445-0297
Mailing Address - Fax:
Practice Address - Street 1:25524 LAWN ST APT B110
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-3883
Practice Address - Country:US
Practice Address - Phone:248-835-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health