Individual
LEANDRA DANIELLE SOLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 BIRCH CIR, PORT WENTWORTH, GA 31407-3322
(512) 496-8536
Mailing address
108 BIRCH CIR, PORT WENTWORTH, GA 31407-3322
(512) 496-8536
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
GA
252Y00000X
Early Intervention Provider Agency
Primary
—
GA
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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