Individual
MR. BEVAN LEE LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1150 E SHERMAN BLVD STE 1125, MUSKEGON, MI 49444-1894
(231) 672-3723
(231) 672-6787
Mailing address
85 SANDY POINT DR, HOLLAND, MI 49424-2523
(616) 796-0385
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801016568
MI
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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