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General NPI Number Information
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NPI Number | 1083464937
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Entity Type | Individual
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Provider Name | TIMOTHY ALLEN LASKIS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 137 VONDA KAY CIR
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City | LEXINGTON
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State | SC
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Zip | 29072-9681
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Country | US
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Telephone | 864-303-5916
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 114
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City | LEXINGTON
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State | SC
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Zip | 29071-0114
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Country | US
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Telephone | 864-303-5916
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY35763
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1151
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License Number State | SC
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