Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 10906 | KS |
NPI | 1003301078 |
---|---|
Provider Name | Taylor Rose Leitner |
First Address | Hoxie, KS 67740-0415 |
Second Address | Hoxie, KS 67740-4373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2018 |
Last Update Date | 22/06/2018 |