Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003023656 |
---|---|
Provider Name | Dr. Leslie Ann Ostrow |
First Address | Boston, MA 02210-1960 |
Second Address | Jamaica Plain, MA 02130-2667 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |