Individual
MS. LESLIE ANN GROOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L,P,C,C,
Contact information
Practice address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC01005
MN
163W00000X
Registered Nurse
R 106172-1
MN
Other
Enumeration date
06/04/2015
Last updated
08/04/2015
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