Individual provider · Type 1 NPI
Larry Liedke
Addiction (Substance Use Disorder) Counselor · Wauchula, FL
NPI number
1043614977
Active
Practice location
125 W Main St, Suit B
Wauchula, FL 33873-2819
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
About NPI 1043614977
Larry Liedke's National Provider Identifier is 1043614977, issued on Oct 21, 2014. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Wauchula, FL. The record was last updated on Oct 21, 2014.