Healthcare Provider Details

I. General information

NPI: 1437010337
Provider Name (Legal Business Name): REBA LESCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5871 GLENRIDGE DR
ATLANTA GA
30328-5375
US

IV. Provider business mailing address

1178 ARBORVISTA DR NE
ATLANTA GA
30329-3841
US

V. Phone/Fax

Practice location:
  • Phone: 917-613-1737
  • Fax:
Mailing address:
  • Phone: 917-613-1737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: