Individual
DR. JOHN LESO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6723 WHITTIER AVE, MC LEAN, VA 22101-4522
(703) 475-6478
Mailing address
120 HOMEWOOD RD, LINTHICUM, MD 21090-2604
(202) 412-2970
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
013429-1
NY
103TC0700X
Clinical Psychologist
Primary
08100055555
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810005555
CLINICAL PSYCHOLOGY LICENSE
VA
Enumeration date
08/03/2017
Last updated
06/06/2022
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