MEDICARE: MRS. ASHLEY R LEFLORE PH.D.

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
1	103T00000X	Psychologist	1349	OK

General Provider Information

NPI Number	:	1821386079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY R LEFLORE PH.D.

Provider Business Mailing Address
First Line	:	5272 S LEWIS AVE STE 277
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-6544
Country	:	US
Telephone Number	:	918-205-4797
Fax Number	:	866-598-3110

Provider Business Practice Location Address
First Line	:	5272 S LEWIS AVE STE 277
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-6544
Country	:	US
Telephone Number	:	918-205-4797
Fax Number	:	866-598-3110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	07/09/2022

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