Individual
REBECCA M LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2579 JOHN MILTON DR STE 210, HERNDON, VA 20171-2564
(703) 214-4924
Mailing address
2579 JOHN MILTON DR STE 210, HERNDON, VA 20171-2564
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704014549
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0704014549
RESIDENT IN COUNSELING LICENSE
VA
Enumeration date
03/24/2022
Last updated
03/24/2022
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