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Individual

DR. LESLIE DIANE BESSELLIEU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2611 FOREST DR STE 114A, COLUMBIA, SC 29204-2372
(803) 463-4910
Mailing address
2611 FOREST DR STE 114A, COLUMBIA, SC 29204-2372
(803) 463-4910

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00778
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PS 0338
SC
Enumeration date
11/06/2006
Last updated
07/08/2007
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