Individual
DR. BRUCE A. LEESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY RO 269
MO
103TF0200X
Forensic Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50331
NATIONAL REGISTER OF HEALTHCARE PROVIDERS IN PSYCHOLOGY
—
Enumeration date
07/26/2006
Last updated
04/03/2013
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