Provider Demographics
NPI:1780234294
Name:HART, LESLEY ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:ANNE
Last Name:HART
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 COURT A
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-5226
Mailing Address - Country:US
Mailing Address - Phone:253-269-6063
Mailing Address - Fax:855-236-8976
Practice Address - Street 1:711 COURT A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-5226
Practice Address - Country:US
Practice Address - Phone:253-269-6063
Practice Address - Fax:855-236-8976
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist