Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003343039 |
---|---|
Provider Name | Brittany Leonard |
First Address | Philadelphia, PA 19154-1304 |
Second Address | Jenkintown, PA 19046-2142 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2017 |
Last Update Date | 22/05/2017 |