| Doctor Name: | MRS. LESLIE MARIE MARTIN |
| NPI Number: | 1831210483 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, CSAC |
| License Number: | 0904005772 |
| Business Practice Address: | 108 Elden St Suite 15-c Herndon, VA - 201704828 |
| Business Phone Number: | 7037966380 |
| Business Fax Number: | 7037966381 |
| Mailing Address: | 6805 Innesfree Way, GAINESVILLE |
| State: | VA |
| Postal Code: | 201554414 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 0904005772 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |