Individual
MS. LESLIE AS DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
322 N MAIN ST, KOKOMO, IN 46901-4622
(765) 453-8555
(765) 453-8020
Mailing address
6626 E 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7561
(317) 355-6096
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
34005269A
IN
Other
Enumeration date
04/20/2007
Last updated
12/17/2018
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