Provider Demographics
NPI:1770237760
Name:MORALES, LESLIE (MOTR)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:MOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16553 RESERVOIR LOOP
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-6851
Mailing Address - Country:US
Mailing Address - Phone:276-791-9396
Mailing Address - Fax:
Practice Address - Street 1:700 W BROAD ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3219
Practice Address - Country:US
Practice Address - Phone:703-440-7909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist