Individual
LESLIE RALPH PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
120 WILLIAM PENN PLAZA, DURHAM, NC 27704-2150
(919) 220-5255
(919) 220-6971
Mailing address
120 WILLIAM PENN PLAZA, DURHAM, NC 27704-2150
(919) 220-5255
(919) 220-6971
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1674
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000458
—
NC
Enumeration date
12/19/2005
Last updated
05/18/2022
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