Provider Demographics
NPI:1780008946
Name:POWDAR, LENIECIA
Entity Type:Individual
Prefix:MRS
First Name:LENIECIA
Middle Name:
Last Name:POWDAR
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 1:2598 FIELDSTONE DR SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-1923
Mailing Address - Country:US
Mailing Address - Phone:404-664-5524
Mailing Address - Fax:
Practice Address - Street 1:2598 FIELDSTONE DR SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1923
Practice Address - Country:US
Practice Address - Phone:404-664-5524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-08
Last Update Date:2014-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator