Doctor Name: | JUDYTH A LEAVITT |
NPI Number: | 1083927198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW, MLADC |
License Number: | 0631 |
Business Practice Address: | 172 Marcy Hill Rd Swanzey, NH - 034462108 |
Business Phone Number: | 6034482705 |
Business Fax Number: | |
Mailing Address: | 172 Marcy Hill Rd, SWANZEY |
State: | NH |
Postal Code: | 034462108 |
Phone Number: | 6034482705 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2010 |
NPI Last Update Date: | 07/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 0631 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |