Provider Demographics
NPI:1174031827
Name:EARL, LESLIE ALLISON (LPC)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:ALLISON
Last Name:EARL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 WILLOWPOINT DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4912
Mailing Address - Country:US
Mailing Address - Phone:405-609-4288
Mailing Address - Fax:
Practice Address - Street 1:7917 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-4540
Practice Address - Country:US
Practice Address - Phone:405-938-1192
Practice Address - Fax:405-938-1193
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty