Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1604 | DC |
N | 103T00000X | Psychologist | 1604 | DC |
Y | 102L00000X | Psychologist | 2840 | MD |
Y | 103T00000X | Psychologist | 2840 | MD |
N | 102L00000X | Psychologist | 9190 | NY |
N | 103T00000X | Psychologist | 9190 | NY |
NPI | 1003897422 |
---|---|
Provider Name | Dr. Irene W Leigh |
First Address | Rockville, MD 20852-3463 |
Second Address | Rockville, MD 20852-3463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2005 |
Last Update Date | 08/07/2007 |