Leslie K Gannon
NPI #1316295272 in Whitefish Bay, Wisconsin
Provider Information
- NPI Number
- 1316295272
- Entity Type
- Individual
- Name
- Leslie K Gannon
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Aug 27, 2012
- Last Updated
- Aug 27, 2012
Practice Location
- Address
- 5573 N DIVERSEY BLVD
- City
- Whitefish Bay
- State
- Wisconsin
- ZIP Code
- 53217-5202
- Phone
- (414) 526-7622
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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