Provider Demographics
NPI:1043584618
Name:JOVEN, LESLIE NATALIE (DN)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:NATALIE
Last Name:JOVEN
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 CERRILLOS RD STE 407
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-2653
Mailing Address - Country:US
Mailing Address - Phone:505-424-8990
Mailing Address - Fax:
Practice Address - Street 1:3600 CERRILLOS RD STE 407
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2653
Practice Address - Country:US
Practice Address - Phone:505-424-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0020172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath