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NPI Code Detail

MEDICARE: MR. WILLIAM HART LESCHEY III PHD

MEDICARE:  MR. WILLIAM HART LESCHEY III PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPS1091ME

General Provider Information

NPI Number : 1235192477
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM HART LESCHEY III PHD
Provider Business Mailing Address
First Line : 107 DELANO PARK
Second Line :
City : CAPE ELIZABETH
State : ME
Zip : 04107-1934
Country : US
Telephone Number : 207-799-3813
Fax Number :
Provider Business Practice Location Address
First Line : 165 LANCASTER ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-2406
Country : US
Telephone Number : 207-874-1030
Fax Number : 207-874-1044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 01/23/2015

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