Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | STATE DOESN'T LICENS | LA |
NPI | 1245517994 |
---|---|
Provider Name | Dr. Leslie E. Bartley |
First Address | Shreveport, LA 71119-7301 |
Second Address | Shreveport, LA 71119-7301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2011 |
Last Update Date | 09/11/2011 |