Provider Demographics
NPI:1922415348
Name:DORSEY, LAKISHA (ATC, LAT, CES)
Entity type:Individual
Prefix:
First Name:LAKISHA
Middle Name:
Last Name:DORSEY
Suffix:
Gender:F
Credentials:ATC, LAT, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 N SAM HOUSTON PKWY E STE 150
Mailing Address - Street 2:125
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4382
Mailing Address - Country:US
Mailing Address - Phone:210-663-3513
Mailing Address - Fax:
Practice Address - Street 1:311 S HOUSTON AVE
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4794
Practice Address - Country:US
Practice Address - Phone:210-663-3513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT52572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer