Provider Demographics
NPI:1568024479
Name:LAWTON, CHEYENNE ELVIA
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:ELVIA
Last Name:LAWTON
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 1:901 W TRADE ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-1143
Mailing Address - Country:US
Mailing Address - Phone:704-440-3580
Mailing Address - Fax:
Practice Address - Street 1:901 W TRADE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-1143
Practice Address - Country:US
Practice Address - Phone:704-440-3580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty