Provider Demographics
NPI:1992942957
Name:PICKLE, LESLIE HESTER (OTD, R/L)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:HESTER
Last Name:PICKLE
Suffix:
Gender:F
Credentials:OTD, R/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 HIGHPOINTE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042
Mailing Address - Country:US
Mailing Address - Phone:601-824-8814
Mailing Address - Fax:601-824-8816
Practice Address - Street 1:2015 HIGHPOINTE DRIVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042
Practice Address - Country:US
Practice Address - Phone:601-824-8814
Practice Address - Fax:601-824-8816
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist