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NPI Code Detail

MEDICARE: DR. LESLIE CLAIRE GUDITIS PH.D., LMFT-S

MEDICARE:  DR. LESLIE CLAIRE GUDITIS  PH.D., LMFT-S
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
1106H00000XMarriage & Family Therapist201286TX

General Provider Information

NPI Number : 1518285832
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE CLAIRE GUDITIS PH.D., LMFT-S
Provider Business Mailing Address
First Line : 15 GREENWAY PLZ
Second Line : 20K
City : HOUSTON
State : TX
Zip : 77046-1509
Country : US
Telephone Number : 940-594-2370
Fax Number :
Provider Business Practice Location Address
First Line : 15 GREENWAY PLZ
Second Line : 20K
City : HOUSTON
State : TX
Zip : 77046-1509
Country : US
Telephone Number : 940-594-2370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2010
Last Update Date : 07/15/2013

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Directions to “ DR. LESLIE CLAIRE GUDITIS PH.D., LMFT-S” Practice Location

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