| NPI | 1750625372 |
|---|---|
| Former Name | MICHELLE L LESLIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042755A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39002420A) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2014-07-17 |