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General NPI Number Information
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NPI Number | 1013208610
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Entity Type | Individual
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Provider Name | MS. LESLIE SUAREZ
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Gender | Female
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Dates
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Enumeration Date | 04/29/2011
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 1551 FORUM PLACE BUILDING, 400 D&E
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City | WEST PALM BEACH
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State | FL
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Zip | 33401
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Country | US
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Telephone | 561-616-8412
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Fax |
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Provider Business Mailing Address
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Address Line | 2097 SW TRENTON LN
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City | PORT ST LUCIE
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State | FL
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Zip | 34984-4322
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Country | US
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Telephone | 772-519-6894
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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