Individual
LEISA DUKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
304 ARLINGTON DR, VIDALIA, GA 30474-8935
(912) 537-1414
Mailing address
1309 CENTER DR, VIDALIA, GA 30474-5213
(912) 293-6329
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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