Individual
DAPHINE LEAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1925 GREENSPRING DR, TIMONIUM, MD 21093-4128
(410) 453-9553
Mailing address
1925 GREENSPRING DR, TIMONIUM, MD 21093-4128
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SC1763
MD
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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