Individual
AMANDA LEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1562 DAIRY RD, CHARLOTTESVILLE, VA 22903-1304
(434) 960-9973
Mailing address
2918 HANES AVE UNIT B, RICHMOND, VA 23222-3607
(434) 245-2889
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904019170
VA
Other
Enumeration date
11/03/2025
Last updated
11/03/2025
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