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1851814008
ASHLEY MEDORA LE GRANGE
PORT ST LUCIE, FL
NPI
1851814008
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: FL MH12264)
Enumeration Date
2017-07-19
Last Update Date
2017-07-19
Business Address
ASHLEY MEDORA LE GRANGE LMHC
1801 SE HILLMOOR DR
PORT ST LUCIE, FL 34952-7553
Phone number: 772-204-2895
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Mailing Address
ASHLEY MEDORA LE GRANGE LMHC
3793 SW PHEASANT RUN
PALM CITY, FL 34990-2581
Phone number: 772-263-3974
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