Healthcare Provider Details

I. General information

NPI: 1578010344
Provider Name (Legal Business Name): MRS. LESLIE KONHAEUSER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 THE PKWY
GREER SC
29650-5204
US

IV. Provider business mailing address

108 SPROLES LN
EASLEY SC
29642-1681
US

V. Phone/Fax

Practice location:
  • Phone: 850-778-2535
  • Fax:
Mailing address:
  • Phone: 850-778-2535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: