| Leslie J Wondra Llc | |
|
8958 W State Road 84 Ste 191 Davie FL 33324-4457 | |
| (954) 787-9869 | |
| Not Available |
| Full Name | Leslie J Wondra Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 8958 W State Road 84 Ste 191, Davie, Florida |
| Authorized Official Name and Position | Leslie J Wondra (OWNER) |
| Authorized Official Contact | 9547879869 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leslie J Wondra Llc 8958 W State Road 84 Ste 191 Davie FL 33324-4457 Ph: (954) 787-9869 | Leslie J Wondra Llc 8958 W State Road 84 Ste 191 Davie FL 33324-4457 Ph: (954) 787-9869 |
| NPI Number | 1710464003 |
|---|---|
| Provider Enumeration Date | 07/19/2018 |
| Last Update Date | 04/15/2021 |
| Certification Date | 04/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710464003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-1003 (Wyoming) | Primary |
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