Provider Demographics
NPI:1285217067
Name:MCCALL, LAWANDA MICHELLE
Entity Type:Individual
Prefix:MS
First Name:LAWANDA
Middle Name:MICHELLE
Last Name:MCCALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 ALEXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-1694
Mailing Address - Country:US
Mailing Address - Phone:910-391-9670
Mailing Address - Fax:
Practice Address - Street 1:1321 ALEXWOOD DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-1694
Practice Address - Country:US
Practice Address - Phone:910-391-9670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services