Individual
DR. JOSEPH SHERMAN LEAKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D., LP
Contact information
Practice address
312 W HIGH ST, LEBANON, KY 40033-1428
(270) 692-9559
(270) 692-9236
Mailing address
312 W HIGH ST, LEBANON, KY 40033-1428
(270) 692-9559
(270) 692-9236
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSYPST00219033
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100349680
—
KY
Enumeration date
06/10/2010
Last updated
07/24/2015
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