Individual
MRS. BETTY J LEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 CENTER ST # A, CHESTER, SC 29706-2704
(704) 808-0378
Mailing address
PO BOX 1205, CHESTER, SC 29706-1210
(704) 808-0378
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TR0400X
Rehabilitation Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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