Individual
KENNETH MICHAEL LEITZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 GALE ST, AURORA, IL 60506-5084
(630) 897-1003
Mailing address
3677 FLETCHER LN, AURORA, IL 60506-7159
(319) 540-5996
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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