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1013395052
LEROY STANFORD
CAMDEN, NJ
NPI
1013395052
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: NJ 37LC00215600)
Enumeration Date
2015-05-11
Last Update Date
2015-05-11
Business Address
LEROY STANFORD
2600 MOUNT EPHRAIM AVE SUITE 405
CAMDEN, NJ 08104-3236
Phone number: 856-963-7323
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Mailing Address
LEROY STANFORD
2600 MOUNT EPHRAIM AVE SUITE 405
CAMDEN, NJ 08104-3236
Phone number: 856-963-7323
Copy
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