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Individual
LESLIE ANN SHOWALTER
Active
Individual
LESLIE ANN SHOWALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5077190275789739
CALFRESH
CA
01
—
909258752
BLUE SHIELD OF CALIFORNIA
CA
05
—
94486299F
—
CA
Enumeration date
10/07/2020
Last updated
10/07/2020
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