MEDICARE: KABRIONNA LESHAY BATTLE

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
1	1041C0700X	Clinical Social Worker	P019912	NC

General Provider Information

NPI Number	:	1952178956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KABRIONNA LESHAY BATTLE

Provider Business Mailing Address
First Line	:	58 AZIMUTH CT
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-3102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 AZIMUTH CT
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-3102
Country	:	US
Telephone Number	:	252-231-1341
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2023
Last Update Date	:	12/08/2023

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