Individual
WYVETTE ANGELA TRESSA MARIA LEONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
710 JOHNNIE DODDS BLVD STE 200, MT PLEASANT, SC 29464-3045
(843) 800-1303
Mailing address
4822 PARKSIDE DR, NORTH CHARLESTON, SC 29405-4629
(559) 707-8810
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4627
SC
Other
Enumeration date
11/11/2022
Last updated
11/11/2022
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