Provider Demographics
NPI:1336867290
Name:LYKINS, ALLETT KATHERINE MARY
Entity type:Individual
Prefix:
First Name:ALLETT
Middle Name:KATHERINE MARY
Last Name:LYKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55807-1563
Mailing Address - Country:US
Mailing Address - Phone:218-348-2912
Mailing Address - Fax:
Practice Address - Street 1:4849 IVANHOE ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55804-1131
Practice Address - Country:US
Practice Address - Phone:218-348-2912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN257721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical