Provider Demographics
NPI:1174031827
Name:EARL, LESLIE ALLISON (LPC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ALLISON
Last Name:EARL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 SW 44TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3615
Mailing Address - Country:US
Mailing Address - Phone:405-605-4249
Mailing Address - Fax:405-605-0255
Practice Address - Street 1:1016 SW 44TH ST STE 500
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3615
Practice Address - Country:US
Practice Address - Phone:405-605-4249
Practice Address - Fax:405-605-0255
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty