Individual
ANGIE LEONARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1913 KINGS ROW, SLIDELL, LA 70461-4803
(985) 259-2521
Mailing address
1913 KINGS ROW, SLIDELL, LA 70461-4803
(985) 259-2521
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
008013282
LA
Other
Enumeration date
04/16/2018
Last updated
04/17/2018
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