Provider Demographics
NPI:1346624905
Name:LESLIE, PAMELA D (LISW-S)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:LESLIE
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 ASHLEY OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-6269
Mailing Address - Country:US
Mailing Address - Phone:863-664-2074
Mailing Address - Fax:
Practice Address - Street 1:2012 ASHLEY OAKS CIR
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-6269
Practice Address - Country:US
Practice Address - Phone:863-664-2074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical