Individual
LESLIE THEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1556 LONE OAK DR, NEENAH, WI 54956-6541
(920) 418-1793
Mailing address
1556 LONE OAK DR, NEENAH, WI 54956-6541
(920) 418-1793
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
07/08/2022
Last updated
07/08/2022
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