Individual
LESLIE WADE
Active
Individual
LESLIE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., L.C.S.W.
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004939A
IN
163W00000X
Registered Nurse
28128139A
IN
Other
Enumeration date
01/13/2011
Last updated
01/13/2011
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