Individual
DR. KEVIN S LESLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D, L.C.D.C
Contact information
Practice address
3230 FALL CREEK HWY, SUITE 110, GRANBURY, TX 76049-7909
(817) 776-7003
Mailing address
3230 FALL CREEK HWY, SUITE 110, GRANBURY, TX 76049-7909
(817) 776-7003
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
TX
103TA0400X
Addiction (Substance Use Disorder) Psychologist
10910
TX
103TF0200X
Forensic Psychologist
—
TX
103TP2701X
Group Psychotherapy Psychologist
—
TX
Other
Enumeration date
05/13/2015
Last updated
04/27/2018
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