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General NPI Number Information
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NPI Number | 1285598201
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Entity Type | Individual
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Provider Name | LAKETAH LASHAWN HARPER
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Gender | Female
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Dates
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Enumeration Date | 12/13/2025
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Last Update Date | 12/13/2025
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Provider Practice Location Address
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Address Line | 30 N GOULD ST STE R
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City | SHERIDAN
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State | WY
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Zip | 82801-6317
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Country | US
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Telephone | 205-597-6099
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 2ND AVE N APT 207
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City | BIRMINGHAM
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State | AL
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Zip | 35203-3152
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Country | US
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Telephone | 205-447-3776
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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 | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | 1-112009
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License Number State | AL
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