Doctor Name: | LESLEY L MANN |
NPI Number: | 1285704452 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW, MSW |
License Number: | LW00005896 |
Business Practice Address: | 165 E Hawthorne Ave Colville, WA - 991142629 |
Business Phone Number: | 5096844597 |
Business Fax Number: | |
Mailing Address: | 169 Witham Rd, COLVILLE |
State: | WA |
Postal Code: | 991149230 |
Phone Number: | 5096846526 |
Fax Number: | |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LW00005896 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |