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NPI Code Detail

MEDICARE: LAKILA MARSH

MEDICARE: LAKILA MARSH
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
1103K00000XBehavior AnalystRBT-23257648AL

General Provider Information

NPI Number : 1740967819
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAKILA MARSH
Provider Business Mailing Address
First Line : 415 N RICHARD JACKSON BLVD STE 209
Second Line :
City : PANAMA CITY BEACH
State : FL
Zip : 32407-3694
Country : US
Telephone Number : 850-866-0441
Fax Number :
Provider Business Practice Location Address
First Line : 6125 UNIVERSITY DR NW STE B22
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35806-1765
Country : US
Telephone Number : 850-866-0441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2023
Last Update Date : 06/30/2023

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Directions to “ LAKILA MARSH ” Practice Location

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