Provider Demographics
NPI:1760662456
Name:REYES, LESLIE MICHELLE (BS)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:MICHELLE
Last Name:REYES
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:MICHELLE
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8266
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76307-8266
Mailing Address - Country:US
Mailing Address - Phone:940-696-6200
Mailing Address - Fax:940-696-6210
Practice Address - Street 1:1709 10TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-5010
Practice Address - Country:US
Practice Address - Phone:940-696-6200
Practice Address - Fax:940-696-6210
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator