Doctor Name: | JEANNA LE SUER |
NPI Number: | 1023231198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S |
License Number: | |
Business Practice Address: | 424 E Southway Blvd Kokomo, IN - 469023814 |
Business Phone Number: | 7654809184 |
Business Fax Number: | |
Mailing Address: | 240 N Tillotson Ave, MUNCIE |
State: | IN |
Postal Code: | 473043988 |
Phone Number: | 7652545133 |
Fax Number: | |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |