Provider Demographics
NPI:1417709932
Name:ATLEY, LESLIE MARIA (NBC-HWC)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:MARIA
Last Name:ATLEY
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3177 ALHAMBRA CIR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-3602
Mailing Address - Country:US
Mailing Address - Phone:302-388-6474
Mailing Address - Fax:
Practice Address - Street 1:3177 ALHAMBRA CIR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-3602
Practice Address - Country:US
Practice Address - Phone:302-388-6474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAA-3279156171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach