Individual
LESLIE EDMONDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 8714, SOUTH LAKE TAHOE, CA 96158-1714
(707) 758-0480
Mailing address
PO BOX 8714, SOUTH LAKE TAHOE, CA 96158-1714
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
113370
NV
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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