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NPI Code Detail

MEDICARE: TANYA FRANCES DELEON LCSWA

MEDICARE: TANYA FRANCES DELEON 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 WorkerP007995NC

General Provider Information

NPI Number : 1346673480
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA FRANCES DELEON LCSWA
Provider Business Mailing Address
First Line : 634 SERENE CT NE
Second Line :
City : LELAND
State : NC
Zip : 28451-7793
Country : US
Telephone Number : 845-235-4870
Fax Number : 910-392-9559
Provider Business Practice Location Address
First Line : 2875 WORTH DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-6248
Country : US
Telephone Number : 845-235-4870
Fax Number : 910-392-9559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2013
Last Update Date : 08/13/2013

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Directions to “ TANYA FRANCES DELEON LCSWA” Practice Location

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