Provider Demographics
NPI:1508600909
Name:DRAKEFORD, PHILMECIA KIANA
Entity type:Individual
Prefix:
First Name:PHILMECIA
Middle Name:KIANA
Last Name:DRAKEFORD
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 1:19545 MORRIS POND RD
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4574
Mailing Address - Country:US
Mailing Address - Phone:228-223-5153
Mailing Address - Fax:
Practice Address - Street 1:19545 MORRIS POND RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4574
Practice Address - Country:US
Practice Address - Phone:228-223-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker