Doctor Name: | MRS. LESLEE P GOLDMAN |
NPI Number: | 1023274123 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, ATR-BC |
License Number: | |
Business Practice Address: | 2008 Dempster St Evanston, IL - 602021017 |
Business Phone Number: | 8474488334 |
Business Fax Number: | |
Mailing Address: | 2008 Dempster St, EVANSTON |
State: | IL |
Postal Code: | 602021017 |
Phone Number: | 8474488334 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2008 |
NPI Last Update Date: | 07/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |