| NPI | 1407472137 |
|---|---|
| Professional Name | LESLIE PAGE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD AC2168) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |