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Individual

MS. LAKEITRA HUMPHREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2133652
TX
225200000X
Physical Therapy Assistant
Primary
PTA004101
GA
225200000X
Physical Therapy Assistant
PTA8739
AL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
11/07/2016
Last updated
02/22/2019
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