Provider Demographics
NPI:1760680078
Name:RAINALDI, LESLIE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:RAINALDI
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 1:366 VENTURA DR
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-4600
Mailing Address - Country:US
Mailing Address - Phone:727-667-0693
Mailing Address - Fax:813-250-9852
Practice Address - Street 1:1006 W PLATT ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2116
Practice Address - Country:US
Practice Address - Phone:727-667-0693
Practice Address - Fax:812-250-9852
Is Sole Proprietor?:No
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSY 7482103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical