Individual
EMILY LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
97 ALLEN AVE, PORTLAND, ME 04103-3710
(207) 200-7880
Mailing address
170 BOLTON ST, PORTLAND, ME 04102-2506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CMH0198501
NM
Other
Enumeration date
08/09/2018
Last updated
03/03/2020
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