Doctor Name: | JENNIFER LEONARD |
NPI Number: | 1003218538 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LPC |
License Number: | 880 |
Business Practice Address: | 6000 Kanakanak Road Suite 130 Dillingham, AK - 995760130 |
Business Phone Number: | 9078421230 |
Business Fax Number: | 9078425174 |
Mailing Address: | 6000 Kanakanak Road, Suite 130 DILLINGHAM |
State: | AK |
Postal Code: | 995760130 |
Phone Number: | 9078421230 |
Fax Number: | 9078425174 |
NPI Enumeration Date: | 09/16/2014 |
NPI Last Update Date: | 09/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 880 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |