Provider Information for 1710793443
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DAVID R LETIECQ LPC
Sex: Male
NPI: 1710793443
Last Updated: 2024-12-11
Certification Date: 2024-12-11
Certification Date: 2024-12-11
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1710793443 | ||||||||||||
| Enumeration Date | 2024-12-07 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1520 BELLE VIEW BLVD UNIT 5310 ALEXANDRIA, VA 22307-6530 United States Phone: 401-662-1682 | Fax: | ||||||||||||
| Primary Practice Address | VILLA ROMERO CALLE 43 #86A-25, APTO 505 MEDELLIN, ANTIOQUIA 050032 Colombia Phone: 401-662-1682 | Fax: | ||||||||||||
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