Individual
MRS. LAKESHA I LORD-SUNAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L, CLT
Contact information
Practice address
231 FARMINGTON AVE, FARMINGTON, CT 06032-1915
(860) 677-0005
(860) 677-2727
Mailing address
2412 E 13TH ST, VANCOUVER, WA 98661-4702
(860) 539-9202
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
002842
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011116
HEALTHNET
CT
01
—
11116
CIGNA
CT
01
—
11544836
PROVIDER CAQH ID
CT
01
—
130002842CT01
ANTHEM BLUE CROSS BLUE SH
CT
01
—
753168105
NORTHEAST HEALTHCARE
CT
01
—
7788774
AETNA
—
Enumeration date
02/06/2006
Last updated
11/26/2022
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