Provider Demographics
NPI:1710128129
Name:SLAVIN, LESLEY ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:ANN
Last Name:SLAVIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3627 KILAUEA AVE
Mailing Address - Street 2:ROOM 405
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2317
Mailing Address - Country:US
Mailing Address - Phone:808-733-9358
Mailing Address - Fax:808-733-9875
Practice Address - Street 1:3627 KILAUEA AVE
Practice Address - Street 2:ROOM 405
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2317
Practice Address - Country:US
Practice Address - Phone:808-733-9358
Practice Address - Fax:808-733-9875
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI864103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent