Individual
LEROY STANFORD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 MOUNT EPHRAIM AVE, SUITE 405, CAMDEN, NJ 08104-3236
(856) 963-7323
(856) 963-7324
Mailing address
2600 MOUNT EPHRAIM AVE, SUITE 405, CAMDEN, NJ 08104-3236
(856) 963-7323
(856) 963-7324
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00215600
NJ
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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