Individual
ELISA LEUENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 S SEWARD MERIDIAN PKWY, WASILLA, AK 99654-8312
(907) 631-3520
Mailing address
1401 S SEWARD MERIDIAN PKWY, WASILLA, AK 99654-8312
(907) 631-3520
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1697550
—
AK
Enumeration date
09/03/2019
Last updated
09/03/2019
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