Organization
BODYLIFE WORKS, INC.
Active
Other names
Mandy Leonards, MSW, LCSW
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY LEONARDS MSW, LCSW (OWNER)
(317) 313-0620
Entity
Organization
Contact information
Practice address
10698 BRIARLAKE WOODS DR, SAN DIEGO, CA 92130-4832
(317) 313-0620
Mailing address
10698 BRIARLAKE WOODS DR, SAN DIEGO, CA 92130-4832
(317) 313-0620
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3400744A
LCSW
IN
01
—
99310
LCSW
CA
Enumeration date
06/30/2022
Last updated
06/30/2022
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