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General NPI Number Information
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NPI Number | 1346088549
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Entity Type | Individual
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Provider Name | ASIA TIERRA LEACH MSW, APSW, LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/20/2024
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 9401 W BELOIT RD STE 201
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City | MILWAUKEE
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State | WI
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Zip | 53227-4357
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Country | US
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Telephone | 414-775-2677
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Fax |
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Provider Business Mailing Address
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Address Line | 3323 N 22ND ST
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City | MILWAUKEE
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State | WI
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Zip | 53206-1712
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Country | US
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Telephone | 980-475-2547
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 115565
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 135371-121
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License Number State | WI
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