Organization
LESLIE RHEAULT, LPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE RHEAULT LPC (MENTAL HEALTH THERAPIST)
(541) 499-1088
Entity
Organization
Contact information
Practice address
2191 CANAL ST, MEDFORD, OR 97501-4338
(541) 499-1088
Mailing address
2191 CANAL ST, MEDFORD, OR 97501-4338
(541) 499-1088
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C1655
OR
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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