Provider Demographics
NPI:1568141125
Name:DILLARD, CECELIA LEVERTA
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:LEVERTA
Last Name:DILLARD
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 1:21825 PRIMROSE WILLOW LN UNIT D
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-4840
Mailing Address - Country:US
Mailing Address - Phone:240-326-3373
Mailing Address - Fax:
Practice Address - Street 1:21825 PRIMROSE WILLOW LN UNIT D
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-4840
Practice Address - Country:US
Practice Address - Phone:124-043-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management