Provider Demographics
NPI:1902491392
Name:HOWARD, MALIKA KHADIJAT (NA)
Entity Type:Individual
Prefix:MS
First Name:MALIKA
Middle Name:KHADIJAT
Last Name:HOWARD
Suffix:
Gender:F
Credentials:NA
Other - Prefix:MS
Other - First Name:MALIKA
Other - Middle Name:KHADIJA
Other - Last Name:SERIKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NA
Mailing Address - Street 1:1455 DIXON AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8879
Mailing Address - Country:US
Mailing Address - Phone:303-443-8500
Mailing Address - Fax:
Practice Address - Street 1:1455 DIXON AVENUE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026
Practice Address - Country:US
Practice Address - Phone:303-443-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO171M00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator