Provider Demographics
NPI:1649900960
Name:LLOYD, KHADIDRAH (MFT)
Entity type:Individual
Prefix:
First Name:KHADIDRAH
Middle Name:
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1-3-38 HOTARUGAIKE NISHIMACHI
Mailing Address - Street 2:EDOKEN BELLETOPIA 202
Mailing Address - City:TOYONAKA, OSAKA
Mailing Address - State:JAPAN
Mailing Address - Zip Code:5600036
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1-3-38 HOTARUGAIKE NISHIMACHI
Practice Address - Street 2:EDOKEN BELLETOPIA 202
Practice Address - City:TOYONAKA, OSAKA
Practice Address - State:JAPAN
Practice Address - Zip Code:5600036
Practice Address - Country:JP
Practice Address - Phone:203-450-6486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist