Provider Demographics
NPI:1003358227
Name:ARUNDEL, LESLIE E
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:E
Last Name:ARUNDEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14626 S 25TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-9028
Mailing Address - Country:US
Mailing Address - Phone:760-715-6055
Mailing Address - Fax:
Practice Address - Street 1:16815 S DESERT FOOTHILLS PKWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-8401
Practice Address - Country:US
Practice Address - Phone:480-704-5954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician