| NPI | 1609226612 |
|---|---|
| Former Name | LESLIE FUDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID IBADCC/CADC #10214) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |