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1114791886
DESTANE LEAK
FAYETTEVILLE, NC
NPI
1114791886
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: NC RBT-23-310444)
Enumeration Date
2023-11-13
Last Update Date
2023-11-13
Business Address
DESTANE LEAK
3649 CAPE CENTER DR
FAYETTEVILLE, NC 28304-4457
Phone number: 910-484-1711
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Mailing Address
DESTANE LEAK
568 SANDHURST DR
FAYETTEVILLE, NC 28304-4426
Phone number: 910-484-1711
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