Provider Demographics
NPI:1669203113
Name:SCOTT, LAKICHA MONIQUE
Entity type:Individual
Prefix:MRS
First Name:LAKICHA
Middle Name:MONIQUE
Last Name:SCOTT
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 1:7231 WINDING FINGER
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-2347
Mailing Address - Country:US
Mailing Address - Phone:321-960-0139
Mailing Address - Fax:
Practice Address - Street 1:7231 WINDING FINGER
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-2347
Practice Address - Country:US
Practice Address - Phone:321-960-0139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0060019534376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide