Basic Information
| Provider Information | |||||||||
| NPI: | 1487808739 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KURLAN | ||||||||
| FirstName: | LESLIE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 203 EASTBROOK WAY | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975201165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414827467 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1836 FREMONT ST | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975202537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414825792 | ||||||||
| FaxNumber: | 5414825034 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2008 | ||||||||
| LastUpdateDate: | 11/13/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | L1894 | OR | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.