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NPI Code Detail

MEDICARE: BRIDGET LEONARD

MEDICARE:   BRIDGET  LEONARD
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
11041C0700XClinical Social Worker18865MN

General Provider Information

NPI Number : 1316368616
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGET LEONARD
Provider Business Mailing Address
First Line : 612 S UNION AVE
Second Line :
City : FERGUS FALLS
State : MN
Zip : 56537-2711
Country : US
Telephone Number : 651-587-3884
Fax Number :
Provider Business Practice Location Address
First Line : 612 S UNION AVE
Second Line :
City : FERGUS FALLS
State : MN
Zip : 56537-2711
Country : US
Telephone Number : 651-587-3884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2014
Last Update Date : 01/04/2014

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Directions to “ BRIDGET LEONARD ” Practice Location

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