Provider Demographics
NPI:1376729533
Name:COWARD, LESLEYJILL (MED,MPH, LCAS)
Entity Type:Individual
Prefix:
First Name:LESLEYJILL
Middle Name:
Last Name:COWARD
Suffix:
Gender:F
Credentials:MED,MPH, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TRENT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-613-6598
Mailing Address - Fax:919-668-6110
Practice Address - Street 1:200 TRENT DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-613-6598
Practice Address - Fax:919-668-6110
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)