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Individual

RICHARD THOMAS LESLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
104 S. OHIO, HUMANSVILLE, MO 65674
(417) 754-2223
(417) 754-8046
Mailing address
PO BOX 939, BOLIVAR, MO 65613-0939
(417) 328-6342

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002386
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE AVAILABLE
NONE AVAILABLE
MO
Enumeration date
09/13/2006
Last updated
03/11/2009
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