Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 19005 | MD |
NPI | 1003316332 |
---|---|
Provider Name | Lashawnda Allthea Leslie-Butler |
First Address | Salisbury, MD 21804-5943 |
Second Address | Salisbury, MD 21804-5943 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2018 |
Last Update Date | 13/02/2018 |