| Full Name | Lki |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2365 5th Ave N, St Petersburg, Florida |
| Authorized Official Name and Position | Nyamekye Laird (PSYCHOLOGIST) |
| Authorized Official Contact | 7277939376 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lki 2365 5th Ave N St Petersburg FL 33713-7005 Ph: (727) 793-9376 | Lki 2365 5th Ave N St Petersburg FL 33713-7005 Ph: (727) 793-9376 |
| NPI Number | 1265846208 |
|---|---|
| Provider Enumeration Date | 06/18/2014 |
| Last Update Date | 06/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265846208 | NPI | - | NPPES |
| 9741408 | Other | FL | AETNA |
| 1962588392 | Other | FL | NPI |
| 5932Q | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PY7843 (Florida) | Primary |
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