Provider Demographics
NPI:1114106283
Name:VALENTE, LESLIE M (MPT)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:M
Last Name:VALENTE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 BLUEGRASS CIR
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-7355
Mailing Address - Country:US
Mailing Address - Phone:307-773-8533
Mailing Address - Fax:307-635-7578
Practice Address - Street 1:1950 BLUEGRASS CIR
Practice Address - Street 2:SUITE 110
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-7323
Practice Address - Country:US
Practice Address - Phone:307-634-2626
Practice Address - Fax:307-634-5099
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist