Provider Demographics
NPI:1215795646
Name:CODLING-DICHET, LESLIE MICHELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:MICHELLE
Last Name:CODLING-DICHET
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 1:23 BROOKSIDE DR APT D
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1268
Mailing Address - Country:US
Mailing Address - Phone:480-570-0788
Mailing Address - Fax:
Practice Address - Street 1:23 BROOKSIDE DR APT D
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1268
Practice Address - Country:US
Practice Address - Phone:480-570-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty