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Individual

CARRIE LEAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
115 FARABEE DR N STE C, LAFAYETTE, IN 47905-5933
(765) 532-7890
Mailing address
4307 MAYFLOWER DR, LAFAYETTE, IN 47909-3473

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
IN
1041C0700X
Clinical Social Worker
Primary
34011289A
IN

Other

Enumeration date
10/18/2022
Last updated
09/09/2025
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