Individual
JESSICA LEAVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
193 OAK ST, SUITE 1, NEWTON, MA 02464-1457
(781) 619-1500
(617) 527-0640
Mailing address
193 OAK ST, SUITE 1, NEWTON, MA 02464-1457
(781) 619-1500
(617) 527-0640
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
8820
MA
Other
Enumeration date
04/03/2009
Last updated
04/03/2009
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