Individual
LESLIE MAUNZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,C.C.C.-SLP
Contact information
Practice address
41150 WOODWARD AVE, BLOOMFIELD HILLS, MI 48304-5020
(248) 397-5792
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4584
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101002368
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146678
MEDICARE ID- TYPE UNSPECIFIED
IL
Enumeration date
10/27/2015
Last updated
10/27/2015
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