Individual
TERESA ANN LEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW, ACSW
Contact information
Practice address
322 SOUTH ROSS STREET, VINITA, OK 74301-3930
(918) 244-1685
(918) 256-3661
Mailing address
P.O. BOX 238, VINITA, OK 74301-3930
(918) 244-1685
(918) 256-3661
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890
OK
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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