Individual
MRS. PAMELA JO LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
3847 PINE GROVE AVE, SUITE B, FORT GRATIOT, MI 48059-4265
(810) 966-3730
(810) 985-7350
Mailing address
3847 PINE GROVE AVE, SUITE B, FORT GRATIOT, MI 48059-4265
(810) 966-3730
(810) 985-7350
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
4704185844
MI
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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