Healthcare Provider Details
I. General information
NPI: 1902150360
Provider Name (Legal Business Name): LESLIE HUGHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/06/2012
Last Update Date: 11/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
285 BIELBY RD
LAWRENCEBURG IN
47025-1055
US
IV. Provider business mailing address
427 W EADS PKWY
LAWRENCEBURG IN
47025-1139
US
V. Phone/Fax
- Phone: 859-537-1302
- Fax: 812-537-0194
- Phone: 812-537-7375
- Fax: 812-537-5271
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: