Organization
MI PAZ COUNSELING KENNY AND LESLIE GALLEGOS LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE ROMERO-GALLEGOS LCSW (LICENSED CLINICAL SOCIAL WORKER)
(909) 810-7209
Entity
Organization
Contact information
Practice address
11799 SEBASTIAN WAY STE 103, RANCHO CUCAMONGA, CA 91730-0708
(909) 810-7209
Mailing address
11799 SEBASTIAN WAY STE 103, RANCHO CUCAMONGA, CA 91730-0708
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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