Provider Demographics
NPI:1356462444
Name:ADAMS, LESLIE HELENA
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:HELENA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:HELENA
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OCCUPATIONAL THERAPI
Mailing Address - Street 1:4220 ERNA DR APT 2
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-5537
Mailing Address - Country:US
Mailing Address - Phone:314-303-4989
Mailing Address - Fax:
Practice Address - Street 1:SUPPLEMENTAL HEALTH CARE 11701 BORMAN DR.
Practice Address - Street 2:280
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146
Practice Address - Country:US
Practice Address - Phone:314-983-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000164014225X00000X
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist