MEDICARE: MISS EMILY JOAN LEON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LAMFT-08034T	AZ

General Provider Information

NPI Number	:	1144090572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS EMILY JOAN LEON

Provider Business Mailing Address
First Line	:	5980 S COOPER RD STE 1
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85249-5394
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20185 E OCOTILLO RD STE 102
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-7663
Country	:	US
Telephone Number	:	480-704-3474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2024
Last Update Date	:	01/05/2024

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Directions to “ MISS EMILY JOAN LEON ” Practice Location

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