Individual
SANDRA DENISE LASSITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1812 LIBERTY ST, DURHAM, NC 27703-2271
(919) 384-5758
Mailing address
1812 LIBERTY ST, DURHAM, NC 27703-2271
(919) 384-5758
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
2022-2799-01
NC
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
06/08/2022
Last updated
08/18/2022
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