Individual
ALISSA ANNE LEISURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PC MED.
Contact information
Practice address
118 PUTNAM ST, MARIETTA, OH 45750-2923
(740) 374-6989
Mailing address
118 PUTNAM ST, MARIETTA, OH 45750-2923
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C0008121
OH
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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