Provider Demographics
NPI:1467666875
Name:DAVIES-LILLY, LESLIE DEVON (MASTERS)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:DEVON
Last Name:DAVIES-LILLY
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FARMERS LN
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-3078
Mailing Address - Country:US
Mailing Address - Phone:860-210-9840
Mailing Address - Fax:
Practice Address - Street 1:100 COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3098
Practice Address - Country:US
Practice Address - Phone:860-482-8561
Practice Address - Fax:860-489-5261
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001474101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor