Individual
BLANDINE R. LEAVITT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1016 COURT ST, MEDFORD, OR 97501-5728
(541) 776-7601
(541) 776-3007
Mailing address
PO BOX 8120, MEDFORD, OR 97504-0120
(541) 776-7601
(541) 776-3007
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0341
OR
Other
Enumeration date
03/27/2006
Last updated
07/08/2007
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