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Individual
BRIAN DOUGLAS LEIDAL
Active
Individual
BRIAN DOUGLAS LEIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA LPC CMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10460707-6004
UT
101YM0800X
Mental Health Counselor
Primary
6401223256
MI
101YM0800X
Mental Health Counselor
MHC01319
RI
101YP2500X
Professional Counselor
LPC.0013400
CO
Other
Enumeration date
10/11/2021
Last updated
09/05/2023
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