Provider Demographics
NPI:1619105574
Name:MANOEL, LETICIA MARIA GORNI (LGSW)
Entity Type:Individual
Prefix:
First Name:LETICIA MARIA
Middle Name:GORNI
Last Name:MANOEL
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5708 CHAPMAN MILL DR APT 160
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5569
Mailing Address - Country:US
Mailing Address - Phone:120-224-7820
Mailing Address - Fax:
Practice Address - Street 1:5708 CHAPMAN MILL DR APT 160
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-5569
Practice Address - Country:US
Practice Address - Phone:202-247-8207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14041104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker