Individual
MS. LESLIE MARIE MOFRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN , MSN, CPNP
Contact information
Practice address
2331 MONROE ST, DEARBORN, MI 48124-3009
(313) 792-0345
(313) 792-0346
Mailing address
2331 MONROE ST, DEARBORN, MI 48124-3009
(313) 792-0345
(313) 792-0346
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704201928
MI
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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