Individual
MR. JEFFREY T LEONARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
180 MAIN ST, SUITE 4, FARMINGTON, ME 04938-1921
(207) 778-4315
Mailing address
180 MAIN ST, SUITE 4, FARMINGTON, ME 04938-1921
(207) 778-4315
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS597
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123060099
—
ME
Enumeration date
10/17/2005
Last updated
07/09/2007
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