Individual
LISA J MARTIN-LECKENBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
158 N ADAMS AVE, LEBANON, MO 65536-3021
(417) 597-4572
Mailing address
777 E BATTLEFIELD ST STE 102B, SPRINGFIELD, MO 65807-4829
(417) 597-4572
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2001025783
MO
Other
Enumeration date
10/15/2012
Last updated
10/15/2012
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