Doctor Name: | LESLIE M COBB |
NPI Number: | 1023477908 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | EDS, LPC |
License Number: | 5727 |
Business Practice Address: | 822 Jackson Ave North Augusta, SC - 298413242 |
Business Phone Number: | 8649333821 |
Business Fax Number: | |
Mailing Address: | 822 Jackson Ave, NORTH AUGUSTA |
State: | SC |
Postal Code: | 298413242 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/19/2016 |
NPI Last Update Date: | 02/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 5727 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |