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NPI Profile for GWENDOLYN A DE LEON in LAFAYETTE, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation |
163WR0400X |
| NPI # | 1083405773 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 05/13/2025 | |
| Last updated | 05/13/2025 - More than a year ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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GWENDOLYN A DE LEON
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GWENDOLYN A DE LEON