Provider Demographics
NPI:1972042935
Name:NEAL, LETANYA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:LETANYA
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11812 STONEWOOD GATE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-4018
Mailing Address - Country:US
Mailing Address - Phone:813-786-2335
Mailing Address - Fax:813-252-9930
Practice Address - Street 1:11812 STONEWOOD GATE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-4018
Practice Address - Country:US
Practice Address - Phone:813-786-2335
Practice Address - Fax:813-252-9930
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker