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Individual

BRIAN KEITH LEBARON

Active
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Individual

BRIAN KEITH LEBARON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.C.P.C.

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.006898
IL
101YP2500X
Professional Counselor
178004166
IL
101YP2500X
Professional Counselor
3767-125
WI

Other

Enumeration date
03/28/2007
Last updated
05/12/2008
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