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Individual

MS. WENDY LEIBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1800 PEMBROOK DRIVE, SUITE 300, ORLANDO, FL 32810-1512
(407) 406-2577
Mailing address
2139 JUDITH PL, LONGWOOD, FL 32779-7012
(407) 406-2577

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1679719876
FL
Enumeration date
12/18/2008
Last updated
07/01/2015
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