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General NPI Number Information
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NPI Number | 1629263744
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Entity Type | Individual
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Provider Name | F. TIMOTHY LEONBERGER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 10777 SUNSET OFFICE DR SUITE 315
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City | SAINT LOUIS
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State | MO
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Zip | 63127-1019
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Country | US
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Telephone | 314-965-0101
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Fax | 314-965-2562
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Provider Business Mailing Address
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Address Line | 10777 SUNSET OFFICE DR SUITE 315
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City | SAINT LOUIS
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State | MO
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Zip | 63127-1019
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Country | US
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Telephone | 314-965-0101
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Fax | 314-965-2562
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 01272
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License Number State | MO
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