Provider Demographics
NPI:1487172664
Name:JONES-DIKUWA, LILTOYNTIA
Entity type:Individual
Prefix:
First Name:LILTOYNTIA
Middle Name:
Last Name:JONES-DIKUWA
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 1:1169 EASTERN PKWY STE 3364
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1415
Mailing Address - Country:US
Mailing Address - Phone:502-813-8280
Mailing Address - Fax:
Practice Address - Street 1:1169 EASTERN PKWY
Practice Address - Street 2:SUITE # 3364
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217
Practice Address - Country:US
Practice Address - Phone:502-813-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical