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General NPI Number Information
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NPI Number | 1356974430
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Entity Type | Individual
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Provider Name | LAKENDRIA MONIQUE POWELL
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Gender | Female
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 1008 E 66TH PL
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City | CLEVELAND
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State | OH
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Zip | 44103-1606
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Country | US
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Telephone | 216-269-7706
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Fax |
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Provider Business Mailing Address
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Address Line | 26241 LAKE SHORE BLVD APT 1463
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City | EUCLID
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State | OH
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Zip | 44132-1145
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Country | US
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Telephone | 216-394-3851
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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