Individual
LACONYEA DYLANA PITTS-THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
322 W 55TH AVE, MERRILLVILLE, IN 46410-2006
(219) 985-8695
Mailing address
322 W 55TH AVE, MERRILLVILLE, IN 46410-2006
(219) 985-8695
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006504A
IN
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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