Doctor Name: | DR. LESLIE ANN DELLENBARGER |
NPI Number: | 1174735765 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PY5308 |
Business Practice Address: | 231 Bruton Street Bainbridge, GA - 39818 |
Business Phone Number: | 2292481625 |
Business Fax Number: | |
Mailing Address: | 231 Bruton Street, P.o. Box 7851 BAINBRIDGE |
State: | GA |
Postal Code: | 39818 |
Phone Number: | 2292481625 |
Fax Number: | |
NPI Enumeration Date: | 05/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY5308 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |