Individual
DR. IRVING GLENN LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2311 E STADIUM BLVD, SUITE 208, ANN ARBOR, MI 48104-4833
(734) 662-2055
(734) 662-6268
Mailing address
3117 OVERRIDGE DR, ANN ARBOR, MI 48104-4152
(734) 971-5768
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301002943
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OH14690
BCBS MICHIGAN
MI
Enumeration date
07/04/2006
Last updated
07/08/2007
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