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Individual
LEON MARK CHAMBERLIN
Active
Individual
LEON MARK CHAMBERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
63871
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219906903
—
TX
01
—
8142LL
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/17/2011
Last updated
05/02/2012
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