Healthcare Provider Details

I. General information

NPI: 1386737344
Provider Name (Legal Business Name): DR. LESLIE R. ABRAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 GREENFIELD RD
SOUTH DEERFIELD MA
01373-9753
US

IV. Provider business mailing address

21 LEAD MINE RD
LEVERETT MA
01054-9524
US

V. Phone/Fax

Practice location:
  • Phone: 413-665-2110
  • Fax:
Mailing address:
  • Phone: 413-548-8032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3924
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: