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General NPI Number Information
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NPI Number | 1538546726
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Entity Type | Organization
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Legal Business Name | DR. LESLIE DONNELLY AND ASSOCIATES, LLC
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 116 W MAIN ST SUITE 300
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City | SALISBURY
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State | MD
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Zip | 21801-4905
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Country | US
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Telephone | 443-742-7160
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Fax | 410-546-1048
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Provider Business Mailing Address
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Address Line | 116 W MAIN ST SUITE 300
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City | SALISBURY
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State | MD
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Zip | 21801-4905
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Country | US
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Telephone | 443-742-7160
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Fax | 410-546-1048
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. GWEN ADKINS
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Credential |
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Telephone | 410-742-7160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCM534
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License Number State | MD
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