Individual
MS. LESLIE ANNE MALACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMT
Contact information
Practice address
500 AUTUMN BLVD, #104, LAKEMOOR, IL 60051-6683
(224) 629-0367
Mailing address
500 AUTUMN BLVD, #104, LAKEMOOR, IL 60051-6683
(224) 629-0367
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22.006885
IL
Other
Enumeration date
04/26/2010
Last updated
04/26/2010
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