Individual
LESLYE A RUNKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
53700 GENERATIONS DR, SOUTH BEND, IN 46635-1539
(574) 235-3262
(574) 258-6307
Mailing address
53700 GENERATIONS DR, SOUTH BEND, IN 46635-1539
(574) 235-3262
(574) 258-6307
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001791A
IN
Other
Enumeration date
12/04/2005
Last updated
07/08/2007
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