Individual
LESLIE A SACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2025 EDISON RD, STE A, SOUTH BEND, IN 46637-5600
(574) 287-3223
(574) 287-1667
Mailing address
2025 EDISON RD, STE A, SOUTH BEND, IN 46637-5600
(574) 287-3223
(574) 287-1667
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004612A
IN
Other
Enumeration date
01/14/2008
Last updated
04/11/2016
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