# LEAF AND STONE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356030951
- **Authorized official:** JOHANNAH BLAKE PMHNP-BC (OWNER/PROVIDER)
- **Authorized official phone:** (520) 654-5502

## Contact information

- **Practice address:** 2919 E BROADWAY BLVD \# 205, TUCSON, AZ 85716-5301
- **Practice address phone:** (520) 654-5502
- **Practice address fax:** (520) 842-8765
- **Mailing address:** 3814 E 5TH ST, TUCSON, AZ 85716-5145
- **Mailing address phone:** (520) 372-8575
- **Mailing address fax:** (520) 372-8576

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2023
- **Last updated:** 04/27/2025