Healthcare Provider Details

I. General information

NPI: 1790453132
Provider Name (Legal Business Name): LAKESHA JEAN HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MARKET AVE N
CANTON OH
44702-1083
US

IV. Provider business mailing address

1320 16TH ST SE
MASSILLON OH
44646-8314
US

V. Phone/Fax

Practice location:
  • Phone: 234-226-7350
  • Fax: 330-247-3994
Mailing address:
  • Phone: 330-361-1627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: