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Individual

MRS. LETITIA DAWN CONRAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW-C

Contact information

Practice address
1 IVY LEAF CT, BOYDS, MD 20841-4112
(240) 723-0478
Mailing address
1 IVY LEAF CT, BOYDS, MD 20841-4112
(240) 723-0478

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
19903
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
47-1666424
NONE
MD
Enumeration date
08/27/2014
Last updated
02/23/2017
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