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NPI Code Detail

MEDICARE: MISS LESLIE DILLARD LADC/ LPC CANDIDATES

MEDICARE: MISS LESLIE DILLARD LADC/ LPC CANDIDATES
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1972916062
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LESLIE DILLARD LADC/ LPC CANDIDATES
Provider Business Mailing Address
First Line : 2808 GLEN OAKS DR
Second Line :
City : NORMAN
State : OK
Zip : 73071-4706
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 620 NW 5TH ST STE D
Second Line :
City : MOORE
State : OK
Zip : 73160-3947
Country : US
Telephone Number : 405-208-4469
Fax Number : 405-208-4472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2014
Last Update Date : 05/22/2023

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Directions to “ MISS LESLIE DILLARD LADC/ LPC CANDIDATES” Practice Location

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