Doctor Name: | MR. MURRAY ELLIS LEIMSIEDER |
NPI Number: | 1245544071 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, LAC & CRC |
License Number: | LAC-12472 |
Business Practice Address: | 590 S Ocotillo Ave Benson, AZ - 856026405 |
Business Phone Number: | 5205867080 |
Business Fax Number: | 5205866104 |
Mailing Address: | 590 S Ocotillo Ave, BENSON |
State: | AZ |
Postal Code: | 856026405 |
Phone Number: | 5205867080 |
Fax Number: | 5205866104 |
NPI Enumeration Date: | 08/04/2010 |
NPI Last Update Date: | 08/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LAC-12472 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |