Provider Demographics
NPI:1346606209
Name:GRESHAM, LESLEIGH HOPE (LMFT)
Entity Type:Individual
Prefix:
First Name:LESLEIGH
Middle Name:HOPE
Last Name:GRESHAM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CENTURY PARK S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3949
Mailing Address - Country:US
Mailing Address - Phone:205-529-2731
Mailing Address - Fax:205-383-3253
Practice Address - Street 1:100 CENTURY PARK S
Practice Address - Street 2:SUITE 102
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3949
Practice Address - Country:US
Practice Address - Phone:205-529-2731
Practice Address - Fax:205-383-3253
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL427106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist