Individual
LEISHA R RISTAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
2425 N ANKENY BLVD STE 106, ANKENY, IA 50023-4722
(515) 489-4602
(515) 512-1504
Mailing address
2425 N ANKENY BLVD STE 106, ANKENY, IA 50023-4711
(515) 489-4602
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007931
IA
Other
Enumeration date
07/30/2012
Last updated
02/27/2024
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