Provider Demographics
NPI:1801151972
Name:JADIN, LESLIE MOORE (PHD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:MOORE
Last Name:JADIN
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 1:1614 S ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6407
Mailing Address - Country:US
Mailing Address - Phone:202-429-9296
Mailing Address - Fax:
Practice Address - Street 1:910 17TH ST NW
Practice Address - Street 2:SUITE 1010
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2601
Practice Address - Country:US
Practice Address - Phone:202-429-9296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1104103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical