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Individual

LESLIE CARROLL OUSLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
217 NORTH MADISON STREET, SUITE 4, GREEN BAY, WI 54301-5012
(920) 227-7078
(920) 273-8847
Mailing address
217 N MADISON ST, SUITE 4, GREEN BAY, WI 54301-5103
(920) 227-7078
(920) 273-8847

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5428-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100037704
WI
05
47-1086793
WI
Enumeration date
06/20/2013
Last updated
04/22/2022
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