Individual
MONIQUE AMBER LEATHERBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15450 COUNTY ROAD 99, WOODLAND, CA 95695-9339
(530) 668-9627
(530) 668-8528
Mailing address
1180 MATMOR RD APT 346, WOODLAND, CA 95776-6359
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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