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General NPI Number Information
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NPI Number | 1265993547
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Entity Type | Organization
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Legal Business Name | LESLIE EDWARDS MA LPC PLLC
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 17806 IH 10 W STE 300
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City | SAN ANTONIO
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State | TX
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Zip | 78257-8222
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Country | US
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Telephone | 210-693-7131
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Fax |
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Provider Business Mailing Address
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Address Line | 18203 ABINGDON PL
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City | SAN ANTONIO
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State | TX
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Zip | 78257-5076
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/LPC
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Name | LESLIE EDWARDS
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Credential |
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Telephone | 210-693-7131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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