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Individual

DR. CYNTHIA ANN LEASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 224-1957
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 224-1957

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002492
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
087373
SENTARA
01
250254
MAMSI
01
253567
VALUE OPTIONS
01
280449
MAGELLAN
01
39373
ANTHEM BCBS
05
7708084
VA
Enumeration date
03/31/2006
Last updated
05/19/2009
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