Individual
ANTHONY LEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
1203 AMERICAN GREETING CARD RD, CORBIN, KY 40701-4811
(606) 528-7010
Mailing address
154 HANOVER DR, LONDON, KY 40741-9775
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
253296
KY
1041C0700X
Clinical Social Worker
Primary
255508
KY
Other
Enumeration date
10/25/2018
Last updated
02/10/2021
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