Individual
LEILA ELIZABETH MORTAZAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
720 ESKEANZI AVE, INDIANAPOLIS, IN 46202-5166
(317) 880-7666
(317) 880-0448
Mailing address
10824 RUCKLE ST, INDIANAPOLIS, IN 46280-1031
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/24/2018
Last updated
11/24/2021
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