Individual
LESLIE S BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5 NEPONSET ST FL STREET12, WORCESTER, MA 01606-2714
(508) 856-0732
(508) 425-5126
Mailing address
5 NEPONSET ST FL ST12, WORCESTER, MA 01606-2714
(508) 856-0732
(508) 425-5126
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4993
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
PRIVATE HEALTHCARE SYSTEM
—
01
—
1033725
CIGNA HEALTH PLAN
—
01
—
2044402
FIRST HEALTH
—
01
—
3690555
AETNA US HEALTHCARE
—
01
—
787395
MVP HEALTH CARE
—
01
—
86903
CHILDRENS MEDICAL SECURIT
—
01
—
990038
FALLON COMMUNITY HEALTH P
—
01
—
W05547
BLUE SHIELD INDEMNITY
—
01
—
W50128
MEDICARE B
—
Enumeration date
01/03/2006
Last updated
09/26/2018
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