Individual
PRISCILLA F LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
936 MARKET ST, PARKERSBURG, WV 26101
(304) 422-7300
(304) 428-3719
Mailing address
936 MARKET ST, PARKERSBURG, WV 26101
(304) 422-7300
(304) 428-3719
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
414
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0162899000
—
WV
Enumeration date
04/21/2006
Last updated
11/06/2007
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