Provider Demographics
NPI:1063500130
Name:SANDERS, LESLEY KATHRYN (PSYCHOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:KATHRYN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 IRVING STREET, NW
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:301-367-4827
Mailing Address - Fax:
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:SUITE 2300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:301-367-4827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04145103TC0700X
DCPSY1000292103TC0700X
VA0810003455103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPSY1000292OtherSTATE LICENSE
VA0810003455OtherSTATE LICENSE
MD04145OtherSTATE LICENSE