Individual
LEIGH DIOTALEVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
11563
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SW1478
—
SC
Enumeration date
01/27/2016
Last updated
04/16/2018
Update your record
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