Provider Demographics
NPI:1013246594
Name:MARSAL, LESLEY CATHRYN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:CATHRYN
Last Name:MARSAL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:LESLEY
Other - Middle Name:CATHRYN
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2200 LAKESHORE DR
Mailing Address - Street 2:STE. 150
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-8803
Mailing Address - Country:US
Mailing Address - Phone:334-793-1881
Mailing Address - Fax:334-340-5918
Practice Address - Street 1:126 CLINIC DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-1980
Practice Address - Country:US
Practice Address - Phone:334-793-1881
Practice Address - Fax:334-340-5918
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1600103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist