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Individual
DR. LESLIE JEAN BENNETT THAYER
Active
Individual
DR. LESLIE JEAN BENNETT THAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
27726
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/02/2007
Last updated
04/27/2016
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