Individual
LESLIE RISIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
731 E MAIN ST, UNIT 13, JACKSON, OH 45640-2100
(740) 286-8789
(740) 286-8789
Mailing address
731 E MAIN ST, UNIT 13, JACKSON, OH 45640-2100
(740) 286-8789
(740) 286-8789
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4453
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0904301
—
OH
Enumeration date
10/04/2006
Last updated
11/02/2012
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