Provider Demographics
NPI:1881716132
Name:DESECOTTIER, LEON RENAULT
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:RENAULT
Last Name:DESECOTTIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 SW 119TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-4500
Mailing Address - Country:US
Mailing Address - Phone:405-301-2423
Mailing Address - Fax:
Practice Address - Street 1:3500 SW 119TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-4500
Practice Address - Country:US
Practice Address - Phone:405-301-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor