Provider Demographics
NPI:1295976140
Name:ROSENSTEIN, LESLIE DEE (PHD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:DEE
Last Name:ROSENSTEIN
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 1:1600 W 38TH ST STE 421
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6407
Mailing Address - Country:US
Mailing Address - Phone:512-454-9429
Mailing Address - Fax:512-454-9429
Practice Address - Street 1:1600 W 38TH ST STE 421
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6407
Practice Address - Country:US
Practice Address - Phone:512-454-9429
Practice Address - Fax:512-454-9429
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24575103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7371198OtherAETNA