Individual
KORINA LECLERC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
24800 SE STARK ST, GRESHAM, OR 97030-3378
(503) 674-1105
Mailing address
12621 SE ORIENT DR, BORING, OR 97009-9527
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6069
OR
Other
Enumeration date
11/11/2015
Last updated
11/11/2015
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