NPI | 1235113267 |
---|---|
Former Name | LESLIE D LANGHOLF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.010039) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149005930) |
Enumeration Date | 2005-12-02 |
Last Update Date | 2018-10-05 |