Individual
LEONARD LEROY MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3085 S ST MIHIEL CIR, WASILLA, AK 99654-0282
(907) 223-5371
Mailing address
PO BOX 671872, CHUGIAK, AK 99567-1872
(907) 223-5371
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/08/2019
Last updated
02/03/2021
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