Individual
LESLIE CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 TALL OAK CIR, JOHNSON CITY, TN 37601-5193
(423) 833-2264
Mailing address
112 TALL OAK CIR, JOHNSON CITY, TN 37601-5193
(423) 833-2264
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-60648
—
Other
Enumeration date
09/20/2022
Last updated
10/30/2024
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