Tyraine Lamar Leslie
Counselor, Mental Health in Pottstown, PA. Individual provider (NPI-1).
NPI number1164077129
StatusActive
Last updated in NPPESAug 7, 2019
Details
- NPI
- 1164077129
- Entity type
- Individual (NPI-1)
- Name
- Tyraine Lamar Leslie
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 7, 2019
- Last updated
- Aug 7, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
11 Robinson StPottstown, PA 19464-6421
Phone 484-941-0500
Mailing address
11 Robinson StPottstown, PA 19464-6421
Phone 484-941-0500
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