Individual
DR. JERRY PATRICK LEAHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3371 MELODY AVE, ROANOKE, VA 24018-3115
(540) 772-0661
Mailing address
3371 MELODY AVE, ROANOKE, VA 24018-3115
(540) 772-0661
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001232
VA
Other
Enumeration date
04/27/2006
Last updated
09/21/2007
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