Individual
ILSE SUCELY DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
170 DAVIDSON HWY STE 201, CONCORD, NC 28027-4255
(980) 209-6328
(704) 298-4206
Mailing address
170 DAVIDSON HWY STE 201, CONCORD, NC 28027-4255
(980) 209-6328
(704) 298-4206
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A15411
NC
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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