Organization
BARRY M LEAVITT AND ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY M LEAVITT PSYD (PRESIDENT)
(847) 441-4111
Entity
Organization
Contact information
Practice address
790 FRONTAGE RD, NORTHFIELD, IL 60093-1204
(847) 441-4111
Mailing address
790 FRONTAGE RD, NORTHFIELD, IL 60093-1204
(847) 441-4111
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071003655
IL
Other
Enumeration date
11/05/2009
Last updated
11/09/2009
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