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Individual
LESLIE WOOD
Active
Individual
LESLIE WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA.171476
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.171476
OH
101YM0800X
Mental Health Counselor
QMHS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0395302
—
OH
Enumeration date
03/17/2020
Last updated
07/17/2020
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