Russell-Martin, Leslie Ann

Russell-Martin, Leslie Ann is an sole proprietor health care provider with primary practice located at 16016 233Rd St , Little Falls MN 56345-5583. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Clinical Neuropsychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Russell-Martin, Leslie Ann can be contacted via phone (320) 632-5524.

Contact Information

Primary practice address
16016 233Rd St Little Falls MN 56345-5583
Phone: (320) 632-5524
Fax: (888) 991-2741
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP4924 Minnesota
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MN #1351 Minnesota
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X LP4924 Minnesota

Profile Details

NPI number 1073603163
LBN Legal business name Russell-Martin, Leslie Ann
Credentials M.S. LMFT PH.D. LP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 13th, 2006
Last updated Oct 24th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073603163 NPPES
Minnesota MEDICAID 360040800
Minnesota Other 730T3RU

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