Provider Demographics
NPI:1134270176
Name:ADAIR, LESLIE KYLE (LP)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:KYLE
Last Name:ADAIR
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 TOWN CENTRE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-1370
Mailing Address - Country:US
Mailing Address - Phone:612-978-1852
Mailing Address - Fax:516-152-3286
Practice Address - Street 1:1121 TOWN CENTRE DR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-1199
Practice Address - Country:US
Practice Address - Phone:612-978-1852
Practice Address - Fax:516-152-3286
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5444103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist