Provider Demographics
NPI:1093233074
Name:LESLIE, KARA (NCPS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:LESLIE
Suffix:
Gender:F
Credentials:NCPS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3504
Mailing Address - Country:US
Mailing Address - Phone:804-673-3775
Mailing Address - Fax:
Practice Address - Street 1:1901 CHARLES ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3504
Practice Address - Country:US
Practice Address - Phone:804-673-3775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool