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General NPI Number Information
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NPI Number | 1962505834
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Entity Type | Organization
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Legal Business Name | EILEEN M LEININGER PHD INC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 794 S BROADWAY
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City | GENEVA
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State | OH
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Zip | 44041-1943
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Country | US
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Telephone | 440-466-7055
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Fax | 440-466-3455
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Provider Business Mailing Address
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Address Line | 794 S BROADWAY
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City | GENEVA
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State | OH
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Zip | 44041-1943
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Country | US
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Telephone | 440-466-7055
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Fax | 440-466-3455
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. EILEEN M LEININGER
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Credential | PHD
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Telephone | 440-466-7055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4950
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License Number State | OH
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