Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
N | 103TC1900X | Counseling Psychologist | ||
Y | 103TS0200X | School Psychologist | 21589414 | OH |
NPI | 1063984151 |
---|---|
Provider Name | Samantha Leeman |
First Address | New Albany, OH 43054-9793 |
Second Address | New Albany, OH 43054-9793 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2018 |
Last Update Date | 29/12/2018 |