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NPI Code Detail

MEDICARE: LESLIE MARIE WELLS LICSW

MEDICARE: LESLIE MARIE WELLS LICSW
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
11041C0700XClinical Social Worker5659CAL

General Provider Information

NPI Number : 1841036787
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE MARIE WELLS LICSW
Provider Business Mailing Address
First Line : 2339 COVE CIR S
Second Line :
City : GADSDEN
State : AL
Zip : 35903-7369
Country : US
Telephone Number : 256-490-6878
Fax Number :
Provider Business Practice Location Address
First Line : 3644 RAINBOW DR
Second Line :
City : RAINBOW CITY
State : AL
Zip : 35906-6313
Country : US
Telephone Number : 256-490-6878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2024
Last Update Date : 07/01/2024

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