Individual
LAKEISHA TANAE FLUELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1 LUPTON AVE, WOODBURY, NJ 08096-5901
(856) 537-5081
Mailing address
1451 ORMOND AVE, CAMDEN, NJ 08103-2925
(856) 383-5094
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL07088400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0991945
—
NJ
Enumeration date
04/24/2024
Last updated
06/26/2024
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