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Individual
MS. LADAVIA TIARA SHONTRELL PRESCOTT
Active
Individual
MS. LADAVIA TIARA SHONTRELL PRESCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWA
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
009525
GA
1041C0700X
Clinical Social Worker
Primary
13776
SC
1041C0700X
Clinical Social Worker
P016113
NC
Other
Enumeration date
08/18/2021
Last updated
09/15/2021
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