Provider Demographics
NPI:1326555848
Name:SMITH, LESLIE NEAL (COUNSELOR/ADDICTION)
Entity Type:Individual
Prefix:MR
First Name:LESLIE
Middle Name:NEAL
Last Name:SMITH
Suffix:
Gender:M
Credentials:COUNSELOR/ADDICTION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 691
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-0691
Mailing Address - Country:US
Mailing Address - Phone:626-316-8731
Mailing Address - Fax:
Practice Address - Street 1:3430 COGSWELL RD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-2785
Practice Address - Country:US
Practice Address - Phone:626-453-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)