Provider Demographics
NPI:1952804635
Name:PERKINS, LAQUINDA DENISE
Entity Type:Individual
Prefix:
First Name:LAQUINDA
Middle Name:DENISE
Last Name:PERKINS
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 1:10025 HILLVIEW DR APT 6
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5743
Mailing Address - Country:US
Mailing Address - Phone:850-255-5005
Mailing Address - Fax:
Practice Address - Street 1:10025 HILLVIEW DR APT 6
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5743
Practice Address - Country:US
Practice Address - Phone:850-255-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty