Individual
LESLIE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LCPC
Contact information
Practice address
7 EAGLE CTR STE B1, O FALLON, IL 62269-1946
(618) 726-2041
(618) 726-2043
Mailing address
7 EAGLE CTR STE B1, O FALLON, IL 62269-1946
(314) 529-0214
(618) 726-2043
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/10/2017
Last updated
07/21/2022
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