Individual
LAKEYTA NACOLE GIVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
514 JOAN ST, MACCLENNY, FL 32063-2618
(904) 947-1244
Mailing address
514 JOAN ST, MACCLENNY, FL 32063-2618
(904) 947-1244
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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