Individual
TISHA LOCKLEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
615 MOSS NECK RD, LUMBERTON, NC 28360-5295
(910) 536-3352
Mailing address
PO BOX 1504, PEMBROKE, NC 28372-1504
(910) 536-3352
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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