Individual
LESTER DACE DELOATCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHS
Contact information
Practice address
1315 WINDRIM AVE, PHILADELPHIA, PA 19141-2710
(215) 456-2707
(215) 456-2713
Mailing address
1315 WINDRIM AVE, PHILADELPHIA, PA 19141-2710
(215) 456-2707
(215) 456-2713
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/14/2007
Last updated
11/14/2007
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