Doctor Name: | MISS TRENT LEIGHTON |
NPI Number: | 1043449804 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD;MA,BA |
License Number: | |
Business Practice Address: | 722 2nd Ave Kotzebue, AK - 997520256 |
Business Phone Number: | 9074427400 |
Business Fax Number: | 9074427822 |
Mailing Address: | 722 2nd Ave, KOTZEBUE |
State: | AK |
Postal Code: | 997520256 |
Phone Number: | 9074427400 |
Fax Number: | 9074427822 |
NPI Enumeration Date: | 07/14/2009 |
NPI Last Update Date: | 07/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |