Individual
ALISHA I LEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
130 S MAIN ST, PRINEVILLE, OR 97754-2744
(541) 350-9366
Mailing address
130 S MAIN ST, PRINEVILLE, OR 97754-2744
(541) 350-9366
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21-CRM-695
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21-CRM-695
CRM LICENSURE
OR
Enumeration date
11/09/2021
Last updated
11/09/2021
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