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NPI Code Detail

MEDICARE: CHRISTINE EDITH LECLERC LADC

MEDICARE: CHRISTINE EDITH LECLERC LADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor01165-LNV

General Provider Information

NPI Number : 1508940560
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE EDITH LECLERC LADC
Provider Business Mailing Address
First Line : 2740 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-5306
Country : US
Telephone Number : 702-248-8866
Fax Number : 702-248-1339
Provider Business Practice Location Address
First Line : 2740 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-5306
Country : US
Telephone Number : 702-248-8866
Fax Number : 702-248-1339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 06/12/2024

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Directions to “ CHRISTINE EDITH LECLERC LADC” Practice Location

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