Provider Demographics
NPI:1295939924
Name:LESLIE, LEIGH A (PHD)
Entity type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:A
Last Name:LESLIE
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 1:2102 BADIAN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5484
Mailing Address - Country:US
Mailing Address - Phone:301-236-4776
Mailing Address - Fax:301-236-4776
Practice Address - Street 1:1109 SPRING ST
Practice Address - Street 2:SUITE 403
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4002
Practice Address - Country:US
Practice Address - Phone:301-236-4776
Practice Address - Fax:301-236-4776
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01742103TF0000X
MDLCM127106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist