Individual
DEANNA THAO LA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1615 POLO RD, WINSTON SALEM, NC 27106-3831
(336) 722-7266
(336) 201-0538
Mailing address
713 S MARSHALL ST, WINSTON SALEM, NC 27101-5808
(336) 722-7266
(336) 201-0538
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C012678
NC
Other
Enumeration date
05/17/2020
Last updated
08/23/2023
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