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Individual

LESLIE LOANZON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RMHCI, MCAP

Contact information

Practice address
4422 E COLUMBUS DR, TAMPA, FL 33605-3233
(813) 384-4203
(813) 984-6729
Mailing address
235 WINDWOOD OAKS DR, #101, TAMPA, FL 33613-1959
(850) 774-3206

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
100000
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
060650200
FL
Enumeration date
06/16/2016
Last updated
06/16/2016
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