Individual
TIANA L LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
7210 W MAIN ST STE 204, BELLEVILLE, IL 62223-3038
(618) 398-9850
(618) 398-9849
Mailing address
7210 W MAIN ST STE 204, BELLEVILLE, IL 62223-3038
(618) 398-9850
(618) 398-9849
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209019641
IL
Other
Enumeration date
07/18/2019
Last updated
05/17/2021
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