Individual
DR. LESLIE ANN DECKTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4075 OLD WESTERN ROW RD, MLC 2047, MASON, OH 45040-3104
(513) 536-4673
(513) 536-0619
Mailing address
4075 OLD WESTERN ROW RD, MLC 2047, MASON, OH 45040-3104
(513) 536-4673
(513) 536-0619
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35.120388
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119954
—
OH
Enumeration date
04/15/2010
Last updated
07/01/2015
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