Provider Demographics
NPI:1386082188
Name:LANKFORD, JALEESA NAASIA
Entity type:Individual
Prefix:
First Name:JALEESA
Middle Name:NAASIA
Last Name:LANKFORD
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 1:98 S MARTIN LUTHER KING BLVD
Mailing Address - Street 2:APT. 415
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4324
Mailing Address - Country:US
Mailing Address - Phone:862-220-7588
Mailing Address - Fax:
Practice Address - Street 1:6396 MCLEOD DR
Practice Address - Street 2:#9
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4428
Practice Address - Country:US
Practice Address - Phone:702-912-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst