| Doctor Name: | DR. DENNIS KEITH LEISENRING |
| NPI Number: | 1013034826 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY D |
| License Number: | 000144 |
| Business Practice Address: | 234 Maple St Box 849 Stowe, VT - 056724248 |
| Business Phone Number: | 8022537337 |
| Business Fax Number: | 8022537332 |
| Mailing Address: | 166 Gold Brook Cir, STOWE |
| State: | VT |
| Postal Code: | 056724535 |
| Phone Number: | 8022538498 |
| Fax Number: | 8022537332 |
| NPI Enumeration Date: | 03/25/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 000144 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |