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Individual
LESLIE MARIE HOMOL
Active
Individual
LESLIE MARIE HOMOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10840
SC
225100000X
Physical Therapist
Primary
P21395
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10840
PHYSICAL THERAPY LICENSE
SC
01
—
28677
PHYSICAL THERAPY LICENSE
MD
01
—
P21395
PT
NC
Enumeration date
09/16/2021
Last updated
03/02/2026
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