Individual
LEANA SUE BAGGETT TALBOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
421 W CONCHO AVE, SAN ANGELO, TX 76903-6310
(325) 500-8465
Mailing address
421 W CONCHO AVE, SAN ANGELO, TX 76903-6310
(325) 500-8465
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
37906
TX
103TF0200X
Forensic Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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