Provider Demographics
NPI:1033599204
Name:BARBOSA, LESLIE KAREN
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:KAREN
Last Name:BARBOSA
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 1:1436 TUCKERMAN ST NW
Mailing Address - Street 2:APT 107
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1097
Mailing Address - Country:US
Mailing Address - Phone:240-593-0421
Mailing Address - Fax:
Practice Address - Street 1:1436 TUCKERMAN ST. NW
Practice Address - Street 2:APT 107
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1097
Practice Address - Country:US
Practice Address - Phone:202-594-0949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11323374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC087493583Medicaid