Provider Demographics
NPI:1043476427
Name:MOHR, LESLIE ANN
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:MOHR
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 1:180 10TH ST SE
Mailing Address - Street 2:P.O. BOX 70
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-2546
Mailing Address - Country:US
Mailing Address - Phone:712-546-4624
Mailing Address - Fax:
Practice Address - Street 1:180 10TH ST SE
Practice Address - Street 2:SUITE 201
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-2546
Practice Address - Country:US
Practice Address - Phone:712-546-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor