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Individual

LESLIE VICTOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
19401 NORTHLINE RD, SOUTHGATE, MI 48195-2277
(734) 785-7718
Mailing address
9671 COLWELL AVE, ALLEN PARK, MI 48101-1312

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary

Other

Enumeration date
09/09/2009
Last updated
09/09/2009
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