Individual
MRS. LESLIE A LILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCAP
Contact information
Practice address
39352 6TH AVE, ZEPHYRHILLS, FL 33542-6844
(813) 696-5706
Mailing address
39352 6TH AVE, ZEPHYRHILLS, FL 33542-6844
(181) 369-6570
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MCAP100501
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3527734
—
FL
Enumeration date
05/04/2022
Last updated
05/04/2022
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