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Individual

LESLI FILLAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
100 EXECUTIVE PARK DR. STE 100, LOUISVILLE, KY 40207-4210
(844) 468-5050
(216) 456-8128
Mailing address
100 EXECUTIVE PARK DR. STE 100, LOUISVILLE, KY 40207-4210
(844) 468-5050
(216) 456-8128

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
168890
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100419140
KY
Enumeration date
06/11/2013
Last updated
05/25/2018
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