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NPI Code Detail

MEDICARE: TAMIKA THORNTON LAWRENCE

MEDICARE: TAMIKA THORNTON LAWRENCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC05124AL

General Provider Information

NPI Number : 1588429724
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMIKA THORNTON LAWRENCE
Provider Business Mailing Address
First Line : 3221 HERBERT DR
Second Line :
City : MONTGOMERY
State : AL
Zip : 36116-3626
Country : US
Telephone Number : 334-538-1774
Fax Number :
Provider Business Practice Location Address
First Line : 3221 HERBERT DR
Second Line :
City : MONTGOMERY
State : AL
Zip : 36116-3626
Country : US
Telephone Number : 334-538-1774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2024
Last Update Date : 02/16/2024

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Directions to “ TAMIKA THORNTON LAWRENCE ” Practice Location

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