Individual
LEENA FATIMA KIZILBASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1826 VETERANS BLVD, DUBLIN, GA 31021-3620
(800) 562-8663
Mailing address
22 HAYDEN ST, ROXBURY CROSSING, MA 02120-3376
(312) 953-2839
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
12966
NH
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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