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General NPI Number Information
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NPI Number | 1558609958
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Entity Type | Organization
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Legal Business Name | LESLIE KIYANFAR
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Dates
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Enumeration Date | 01/21/2013
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 701 PAPWORTH AVE STE 208
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City | METAIRIE
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State | LA
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Zip | 70005-4923
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Country | US
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Telephone | 985-519-3077
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Fax | 985-384-7432
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Provider Business Mailing Address
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Address Line | 1060 OAK HARBOR DR
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City | MORGAN CITY
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State | LA
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Zip | 70380-8041
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Country | US
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Telephone | 985-688-5386
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Fax | 985-384-7432
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | LESLIE KIYANFAR
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Credential | LCSW
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Telephone | 985-688-5386
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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 | 7233
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License Number State | LA
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