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General NPI Number Information
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NPI Number | 1790059277
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Entity Type | Individual
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Provider Name | LESLIE LARO HAYES M.A., M.ED., LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/01/2012
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 1912 AVENUE R
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City | HONDO
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State | TX
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Zip | 78861-2325
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Country | US
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Telephone | 210-218-2152
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N LOOP 1604 E STE. 220
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City | SAN ANTONIO
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State | TX
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Zip | 78232-1238
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Country | US
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Telephone | 210-218-2152
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 201353
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License Number State | TX
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