Provider Demographics
NPI:1346879483
Name:WINSTON, LANNIE
Entity Type:Individual
Prefix:
First Name:LANNIE
Middle Name:
Last Name:WINSTON
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 1:1200 S WEST BLVD STE 1A
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-6472
Mailing Address - Country:US
Mailing Address - Phone:856-305-3350
Mailing Address - Fax:
Practice Address - Street 1:1200 S WEST BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6472
Practice Address - Country:US
Practice Address - Phone:856-305-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker