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NPI Code Detail

MEDICARE: TONYA LEBLANC MSW, LCSWA

MEDICARE: TONYA LEBLANC MSW, LCSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP008182NC

General Provider Information

NPI Number : 1336587682
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONYA LEBLANC MSW, LCSWA
Provider Business Mailing Address
First Line : 192 VILLAGE DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-7238
Country : US
Telephone Number : 910-577-2716
Fax Number :
Provider Business Practice Location Address
First Line : 192 VILLAGE DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-7238
Country : US
Telephone Number : 910-577-2716
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2013
Last Update Date : 06/10/2013

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