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Individual
LEIGH BERGIN MADDY
Active
Individual
LEIGH BERGIN MADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
Primary
S.1803273
OH
175T00000X
Peer Specialist
152112790042
MO
Other
Enumeration date
11/25/2015
Last updated
08/06/2019
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