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General NPI Number Information
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NPI Number | 1104833847
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Entity Type | Individual
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Provider Name | PATRICIA L LEONARD L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3615 CENTRAL AVE SUITE 4
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City | FORT MYERS
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State | FL
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Zip | 33901-8257
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Country | US
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Telephone | 239-278-1140
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Fax |
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Provider Business Mailing Address
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Address Line | 15041 PADDLE CREEK DR APT. 101
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City | FORT MYERS
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State | FL
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Zip | 33919-6940
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW5805
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License Number State | FL
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