institution
Leslie H Petruk Ma Lpc Ncc
Professional Counselor in Charlotte, North Carolina
NPI 1417061466

Leslie H Petruk Ma Lpc Ncc is a Professional Counselor based in Charlotte, NC and is specialized in Professional. Leslie H Petruk Ma Lpc Ncc practices in Charlotte, NC. The NPI Number for Leslie H Petruk Ma Lpc Ncc is 1417061466 and holds a License No. 4290 (North Carolina).

The current practice location address for Leslie H Petruk Ma Lpc Ncc is 1106 Harding Pl, Charlotte, NC and can be reached out via phone at 704-665-0065 and via fax at 704-335-4001.

Location: 1106 Harding Pl, Charlotte, NC, 28204-2825
institution
Provider Profile Details
NPI Number
1417061466
Provider Name
Leslie H Petruk Ma Lpc Ncc
Credential
Provider Entity Type
Organization
Address
1106 Harding Pl, Charlotte, NC, 28204-2825
Phone Number
704-665-0065
Fax Number
704-335-4001
Provider Enumeration Date
08/18/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1386G 01 NC BC/BS PROVIDER NUMBER
6102653 05 NC
institution
Provider Business Practice Location Address Details
Address
1106 Harding Pl
City
State
Zip
28204-2825
Phone Number
704-665-0065
Fax Number
704-335-4001
person
Provider Business Mailing Address Details
Address
1106 Harding Pl
City
State
Zip
28204-2825
Phone Number
704-665-0065
Fax Number
704-335-4001
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
4290 (North Carolina)
Definition
Definition to come...
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