MEDICARE: DR. ANNA LAMIKANRA PH.D

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
1	102X00000X	Poetry Therapist
2	174400000X	Specialist	UNTWISE ALAMIKANRA45	TX
3	174H00000X	Health Educator

General Provider Information

NPI Number	:	1700334638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA LAMIKANRA PH.D

Provider Business Mailing Address
First Line	:	PO BOX 5323
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-0210
Country	:	US
Telephone Number	:	972-538-5943
Fax Number	:	972-294-3309

Provider Business Practice Location Address
First Line	:	5001 SPRING VALLEY RD
Second Line	:	SUITE E 400
City	:	DALLAS
State	:	TX
Zip	:	75244-3946
Country	:	US
Telephone Number	:	972-538-5943
Fax Number	:	972-294-3309

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2016
Last Update Date	:	09/20/2016

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