Individual
HALEY LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS/MHP
Contact information
Practice address
408 E VINE ST, VIENNA, IL 62995-1612
(618) 658-2611
Mailing address
408 E VINE ST, VIENNA, IL 62995-1612
(618) 658-2611
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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