Provider Demographics
NPI:1457758328
Name:LAWSON-DELOATCHE, DIONNA
Entity Type:Individual
Prefix:
First Name:DIONNA
Middle Name:
Last Name:LAWSON-DELOATCHE
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 1:2116 BENNETT ST
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-4002
Mailing Address - Country:US
Mailing Address - Phone:702-927-1580
Mailing Address - Fax:
Practice Address - Street 1:2116 BENNETT ST
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-4002
Practice Address - Country:US
Practice Address - Phone:702-927-1580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner