Provider Demographics
NPI:1972949436
Name:NALDER, LAZETTE MICHELLE (MSW INTERN)
Entity type:Individual
Prefix:MRS
First Name:LAZETTE
Middle Name:MICHELLE
Last Name:NALDER
Suffix:
Gender:F
Credentials:MSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W BAYSHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-5304
Mailing Address - Country:US
Mailing Address - Phone:910-787-7044
Mailing Address - Fax:
Practice Address - Street 1:110 W BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540
Practice Address - Country:US
Practice Address - Phone:910-787-7044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker