Provider Demographics
NPI:1649513698
Name:PAGE, LESLIE MICHELLE (DOULA LSP)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:MICHELLE
Last Name:PAGE
Suffix:
Gender:F
Credentials:DOULA LSP
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:MICHELLE
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOULA LSP
Mailing Address - Street 1:1122 QUEENS PL
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-3264
Mailing Address - Country:US
Mailing Address - Phone:816-942-8855
Mailing Address - Fax:
Practice Address - Street 1:1122 QUEENS PL
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-3264
Practice Address - Country:US
Practice Address - Phone:816-942-8855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator