Individual
MISS HEATHER MARIE LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 W CONVENT ST, LAFAYETTE, LA 70501-6903
(337) 534-0770
Mailing address
113 W CONVENT ST, LAFAYETTE, LA 70501-6903
(337) 534-0770
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10YMO800X
—
LA
Enumeration date
05/12/2017
Last updated
05/12/2017
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