Individual
CORRINA LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 BON AIR RD, UNIT B, GREENBRAE, CA 94904-1702
(415) 473-2523
Mailing address
250 BON AIR RD, UNIT B, GREENBRAE, CA 94904-1702
(415) 473-2523
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/03/2015
Last updated
04/20/2017
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