Individual
TINA LYNN LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 BROOKTREE RD STE 101, WEXFORD, PA 15090-9278
(833) 867-8371
Mailing address
114 DUPONT DR, MC DONALD, PA 15057-2190
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000250
PA
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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