Provider Demographics
NPI:1427481068
Name:ABBOTT, SHAMIKA N
Entity type:Individual
Prefix:
First Name:SHAMIKA
Middle Name:N
Last Name:ABBOTT
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 1:3465 LORILOU LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3570
Mailing Address - Country:US
Mailing Address - Phone:702-547-9972
Mailing Address - Fax:702-547-9974
Practice Address - Street 1:4525 S SANDHILL RD STE 115
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5956
Practice Address - Country:US
Practice Address - Phone:702-547-9972
Practice Address - Fax:702-547-9974
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst