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NPI Code Detail

MEDICARE: LESLIE JUNE YERACE PSYD

MEDICARE: LESLIE JUNE YERACE PSYD
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 PsychologistPS016817PA

General Provider Information

NPI Number : 1881905933
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE JUNE YERACE PSYD
Provider Business Mailing Address
First Line : 3298 CONWAY WALLROSE RD
Second Line :
City : BADEN
State : PA
Zip : 15005-2314
Country : US
Telephone Number : 412-722-6205
Fax Number :
Provider Business Practice Location Address
First Line : 353 N DUFFY RD
Second Line :
City : BUTLER
State : PA
Zip : 16001-1138
Country : US
Telephone Number : 724-285-2510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2010
Last Update Date : 09/19/2023

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