MEDICARE: LESLIE C BROWN LBSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	29234	TX

General Provider Information

NPI Number	:	1225275670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE C BROWN LBSW

Provider Business Mailing Address
First Line	:	3524 EISENHOWER LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75023-3828
Country	:	US
Telephone Number	:	972-896-9986
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 N VALLEY PKWY
Second Line	:	SUITE 380
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-3438
Country	:	US
Telephone Number	:	972-353-5437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	01/07/2009

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