Individual
MRS. LORI LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
14930 LAPLAISANCE RD, SUITE 123, MONROE, MI 48161-3880
(734) 240-3850
(734) 240-3863
Mailing address
146 BONDIE ST, WYANDOTTE, MI 48192-2718
(734) 285-9469
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6801087662
MI
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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