Individual
LESLIE DALENCOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3739 WILKENS AVE, BALTIMORE, MD 21229-5035
(410) 621-9261
(410) 514-3596
Mailing address
5622 OAKLAND MILLS RD, COLUMBIA, MD 21045-3218
(718) 496-4223
(410) 514-3596
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC6559
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589561800
—
MD
Enumeration date
03/20/2013
Last updated
09/22/2021
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