Individual
DEIANIRA C LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LLP
Contact information
Practice address
30701 WOODWARD AVE, STE 200, ROYAL OAK, MI 48073-0987
(248) 288-9333
(248) 288-1362
Mailing address
54 MILLSTONE DR, STE D407, WATERFORD, MI 48328-2954
(734) 604-0247
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401008170
MI
103T00000X
Psychologist
6301016226
MI
Other
Enumeration date
11/07/2014
Last updated
04/07/2017
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