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General NPI Number Information
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NPI Number | 1184886673
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Entity Type | Individual
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Provider Name | LOIS MARIE LEBLANC PH.D
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Gender | Female
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 3425 W MANCHESTER BLVD SUITE 106
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City | INGLEWOOD
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State | CA
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Zip | 90305-2101
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Country | US
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Telephone | 323-778-7254
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Fax | 323-777-1025
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Provider Business Mailing Address
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Address Line | 207 E 92ND ST
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City | LOS ANGELES
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State | CA
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Zip | 90003-3727
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Country | US
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Telephone | 323-778-7254
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Fax | 323-777-1025
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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