Individual
LESLIE NAIN BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
410 TARROW ST STE 102, COLLEGE STATION, TX 77840-7892
(979) 721-6062
Mailing address
410 TARROW ST STE 102, COLLEGE STATION, TX 77840-7892
(979) 721-6062
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
39688
TX
Other
Enumeration date
09/08/2020
Last updated
12/30/2022
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