Individual
BLANCA DE LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
459 E 1ST ST, FOND DU LAC, WI 54935-4505
(920) 929-3579
Mailing address
459 E 1ST ST, FOND DU LAC, WI 54935-4505
(920) 929-3549
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7882-123
WI
Other
Enumeration date
09/19/2007
Last updated
07/01/2013
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