Healthcare Provider Details

I. General information

NPI: 1487720371
Provider Name (Legal Business Name): JOEL DAVID LESSES MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 HERTEL AVE
BUFFALO NY
14207-2341
US

IV. Provider business mailing address

113 YORKTOWN RD
SNYDER NY
14226-4634
US

V. Phone/Fax

Practice location:
  • Phone: 716-834-0282
  • Fax:
Mailing address:
  • Phone: 716-816-5830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: