Larry Liedke

NPI #1043614977 in Wauchula, Florida

Provider Information

NPI Number: 1043614977
Entity Type: Individual
Name: Larry Liedke
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Enumeration Date: Oct 21, 2014
Last Updated: Oct 21, 2014

Practice Location

Address: 125 W MAIN ST
Address 2: SUIT B
City: Wauchula
State: Florida
ZIP Code: 33873-2819
Phone: (863) 448-4332

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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Organizations

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