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General NPI Number Information
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NPI Number | 1124188107
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Entity Type | Individual
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Provider Name | LESLEY ELLEN SCHMALTZ LSW, CSW
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2818 GRANT LINE RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-2492
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Country | US
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Telephone | 812-944-6120
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Fax | 812-941-5726
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Provider Business Mailing Address
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Address Line | 2818 GRANT LINE RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-2492
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Country | US
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Telephone | 812-944-6120
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Fax | 812-941-5726
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5086
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License Number State | KY
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