Individual
BEVERLY LEIGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
CORNER OF LAMONT & VETERANS WAY, BUILDING 160, MOUNTAIN HOME, TN 37684
(423) 817-0721
Mailing address
3348 RIDGEVIEW ST, KINGSPORT, TN 37664-3428
(423) 817-0721
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1793
NE
101YP2500X
Professional Counselor
1644
WY
106H00000X
Marriage & Family Therapist
Primary
843
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1525019
—
TN
Enumeration date
04/01/2011
Last updated
04/27/2020
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