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Individual
LESLIE TUCKER-GUILFOYLE
Active
Individual
LESLIE TUCKER-GUILFOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
0903002435
VA
1041C0700X
Clinical Social Worker
Primary
0904011044
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336293000
—
VA
Enumeration date
06/05/2019
Last updated
02/07/2023
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