Doctor Name: | DR. LESLIE E. BARTLEY |
NPI Number: | 1245517994 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | STATE DOESN'T LICENS |
Business Practice Address: | 3937 Pines Rd Suite H Shreveport, LA - 711197301 |
Business Phone Number: | 3186351668 |
Business Fax Number: | 3186351668 |
Mailing Address: | 3937 Pines Rd, Suite H SHREVEPORT |
State: | LA |
Postal Code: | 711197301 |
Phone Number: | 3186351668 |
Fax Number: | 3186351668 |
NPI Enumeration Date: | 11/09/2011 |
NPI Last Update Date: | 11/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP1600X |
License Number: | STATE DOESN'T LICENS |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Pastoral |
Taxonomy Definition: |