Dehaven, Leslie
Dehaven, Leslie is an individual health care provider with primary practice located at 122 Highway 76 , White House TN 37188-9291. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Dehaven, Leslie can be contacted via phone (615) 672-6896.Contact Information
Primary practice address
122 Highway 76
White House TN 37188-9291
Phone: (615) 672-6896
Fax: (615) 672-6783
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2276 | Tennessee |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1510DT | Kentucky |
Profile Details
| NPI number | 1114081106 |
|---|---|
| LBN Legal business name | Dehaven, Leslie |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2006 |
| Last updated | May 2nd, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114081106 | NPPES |
| Tennessee | MEDICAID | 3944682 |
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