Individual
WANDA IVETTE LEBRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2324 PINE GROVE AVE, TOMS RIVER, NJ 08753-6007
(570) 520-8357
Mailing address
2324 PINE GROVE AVE, TOMS RIVER, NJ 08753-6007
(570) 520-8357
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NJ
Other
Enumeration date
01/20/2023
Last updated
01/20/2023
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