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Individual

BRETT LEIMKHUHLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
512 MAIN ST, WAKEFIELD, RI 02879
(401) 789-7848
(401) 782-2653
Mailing address
PO BOX 69, WAKEFIELD, RI 02880
(401) 789-7848
(401) 782-2653

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS335
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
211338
BCBS RI PROVIDER ID
01
410194
BCBS RI BLUECHIP PROVIDER
Enumeration date
03/26/2007
Last updated
07/08/2007
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