Individual
MR. GERALD E LEISCHNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5401 SW 29TH ST, OKLAHOMA CITY, OK 73179-7602
(405) 681-2003
Mailing address
6217 BROOKSIDE DR, OKLAHOMA CITY, OK 73132-5648
(405) 728-0962
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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