Provider Information for 1356606685
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KATHLEEN LEAF MSW
Sex: Female
NPI: 1356606685
Last Updated: 2012-07-12
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1356606685 | ||||||||
| Enumeration Date | 2012-07-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 133 SE 4TH ST SATELLITE BEACH, FL 32937-2131 United States Phone: 561-460-5586 | Fax: | ||||||||
| Primary Practice Address | 133 SE 4TH ST SATELLITE BEACH, FL 32937-2131 United States Phone: 561-460-5586 | Fax: | ||||||||
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