Individual
MARTHA MARIE LEICHLITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 LOCUST ST, MANNINGTON, WV 26582-1350
(304) 376-3572
Mailing address
201 LOCUST ST, MANNINGTON, WV 26582-1350
(304) 376-3572
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
11/09/2024
Last updated
01/31/2025
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