Individual
JULIE BRENNA LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
66 CANAL ST, BOSTON, MA 02114-2002
(617) 371-3040
Mailing address
66 CANAL ST, BOSTON, MA 02114-2002
(617) 371-3040
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386702264
NPI
MA
Enumeration date
08/25/2009
Last updated
08/25/2009
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