Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-18-31992 | |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 5384 | NC |
NPI | 1013497379 |
---|---|
Provider Name | Ashleigh Lynn Leuck |
First Address | Wilmington, NC 28411-6214 |
Second Address | Wilmington, NC 28411-6214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2018 |
Last Update Date | 04/06/2021 |