Individual
MS. CLARA LYNETTE LEATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
8830 ORCHARD TREE LN, BALTIMORE, MD 21286-2143
(443) 632-3606
Mailing address
908 BOOKER DR, CAPITOL HEIGHTS, MD 20743-1834
(301) 350-2589
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15717
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27-3216860
EMPLOYEE IDENTIFICATION NUMBER
MD
Enumeration date
08/11/2010
Last updated
08/11/2010
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