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NPI Code Detail

MEDICARE: LESLIE LEWALLEN MCQUARY

MEDICARE: LESLIE LEWALLEN MCQUARY
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1386970358
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE LEWALLEN MCQUARY
Provider Business Mailing Address
First Line : 202 PROVIDENCE MINE RD STE 105
Second Line :
City : NEVADA CITY
State : CA
Zip : 95959-2945
Country : US
Telephone Number : 530-575-8179
Fax Number : 530-265-7849
Provider Business Practice Location Address
First Line : 202 PROVIDENCE MINE RD STE 105
Second Line :
City : NEVADA CITY
State : CA
Zip : 95959-2945
Country : US
Telephone Number : 530-575-8179
Fax Number : 530-265-7849
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2009
Last Update Date : 10/27/2009

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Directions to “ LESLIE LEWALLEN MCQUARY ” Practice Location

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