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General NPI Number Information
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NPI Number | 1871653873
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Entity Type | Individual
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Provider Name | LESLIE HELEN VALENTINE OD
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 10/01/2012
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Provider Practice Location Address
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Address Line | 852 WINTER STREET
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City | LUCEDALE
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State | MS
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Zip | 39452
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Country | US
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Telephone | 601-947-3553
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Fax | 601-947-3933
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Provider Business Mailing Address
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Address Line | 852 WINTER STREET
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City | LUCEDALE
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State | MS
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Zip | 39452
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Country | US
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Telephone | 601-947-3553
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Fax | 601-947-3933
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 639
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5903TA472
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License Number State | AL
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