Individual provider · NPI-1

Larita Patrice Dalton

Social Worker · Ellenwood, GA

NPI number1932777802
StatusActive
Last updated in NPPESJun 16, 2021

Details

NPI
1932777802
Entity type
Individual (NPI-1)
Name
Ms. Larita Patrice Dalton
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 16, 2021
Certification date
Jun 16, 2021
Last updated
Jun 16, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
104100000X Social Worker––Yes

Practice location

5641 Sapphire Cir
Ellenwood, GA 30294-3584

Phone 912-492-6828

Mailing address

5641 Sapphire Cir
Ellenwood, GA 30294-3584

Phone 912-492-6828

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