| Larry Liedke, | |
|
125 W Main St, Suit B, Wauchula, FL 33873-2819 | |
| (863) 448-4332 | |
| Not Available |
| Full Name | Larry Liedke |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 125 W Main St, Wauchula, Florida |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043614977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Larry Liedke, 125 W Main St, Suit B, Wauchula, FL 33873-2819 Ph: (863) 448-4332 | Larry Liedke, 125 W Main St, Suit B, Wauchula, FL 33873-2819 Ph: (863) 448-4332 |
Jennifer Martin, LMHC Counselor Medicare: Medicare Enrolled Practice Location: 213 E Orange St, Wauchula, FL 33873 Phone: 863-519-0575 Fax: 863-582-9251 | |
Brandi Horak, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 202 S 9th Ave, Wauchula, FL 33873 Phone: 863-773-2226 |