Individual
LESLIE ANN COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
539 N MAIN ST, CONVOY, OH 45832-7737
(419) 860-0494
Mailing address
13465 CONVOY RD, VAN WERT, OH 45891-8733
(419) 860-0494
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0377215
—
OH
Enumeration date
01/09/2020
Last updated
01/09/2020
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