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General NPI Number Information
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NPI Number | 1356765127
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Entity Type | Organization
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Legal Business Name | LESLIE ANN SHIELDS, PLLC
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 106 E 24TH ST
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City | HOUSTON
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State | TX
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Zip | 77008-2518
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Country | US
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Telephone | 832-858-1411
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 70494
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City | HOUSTON
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State | TX
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Zip | 77270-0494
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Country | US
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Telephone | 832-858-1411
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. LESLIE ANN SHIELDS
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Credential | MS, LPC
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Telephone | 832-858-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 18846
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License Number State | TX
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