Provider Demographics
NPI:1801633599
Name:LYONS, LAKITA
Entity type:Individual
Prefix:
First Name:LAKITA
Middle Name:
Last Name:LYONS
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 S DUPONT BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1704
Mailing Address - Country:US
Mailing Address - Phone:302-422-2612
Mailing Address - Fax:
Practice Address - Street 1:550 S DUPONT BLVD STE A
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1704
Practice Address - Country:US
Practice Address - Phone:302-422-2612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1900462471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography