| Doctor Name: | MS. LESLIE DANIELLE WILLIS |
| NPI Number: | 1083744742 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M. A. SOCIAL WORKER |
| License Number: | B04834 |
| Business Practice Address: | 900 Central Bayard, NM - 88023 |
| Business Phone Number: | 5055374000 |
| Business Fax Number: | 5055373921 |
| Mailing Address: | 95 Burke Loop, SILVER CITY |
| State: | NM |
| Postal Code: | 88061 |
| Phone Number: | 5055374000 |
| Fax Number: | 5055373921 |
| NPI Enumeration Date: | 03/06/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | B04834 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |