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Individual

LEIF ERIC LEAF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
3515 S 4TH ST, PROFESSIONAL ASSOCIATION, LEAVENWORTH, KS 66048
(913) 651-8415
(913) 772-8580
Mailing address
13829 HARBOR DR, BONNER SPRINGS, KS 66012
(913) 441-1640

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
01356
MO
103T00000X
Psychologist
Primary
701
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004517
BCBS OF KANSAS GROUP
01
119716
BCBS OF KANSAS
KS
01
2094031
CIGNA
01
24103022
BCBS OF KC KS
KS
01
5240235
AETNA
Enumeration date
09/13/2006
Last updated
07/08/2007
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