Individual
MS. JO ELLEN LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1300 WINNIPEG DR, LEWISVILLE, TX 75077-2980
(800) 257-8715
Mailing address
1300 WINNIPEG DR, LEWISVILLE, TX 75077-2980
(800) 257-8715
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3-0565
TX
Other
Enumeration date
06/17/2006
Last updated
07/08/2007
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