Provider Demographics
NPI:1992412019
Name:LABOVE, LAKEISHA Y (CRC)
Entity type:Individual
Prefix:MRS
First Name:LAKEISHA
Middle Name:Y
Last Name:LABOVE
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 INDIAN LILAC DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-7205
Mailing Address - Country:US
Mailing Address - Phone:469-767-3421
Mailing Address - Fax:
Practice Address - Street 1:1916 INDIAN LILAC DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-7205
Practice Address - Country:US
Practice Address - Phone:469-767-3421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00084237225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor