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NPI Code Detail

MEDICARE: MRS. GEORGANNA LEAVESLEY PHD

MEDICARE: MRS. GEORGANNA LEAVESLEY PHD
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
1103TC1900XCounseling Psychologist653LA

General Provider Information

NPI Number : 1356492664
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GEORGANNA LEAVESLEY PHD
Provider Business Mailing Address
First Line : 137 N CLARK ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-5207
Country : US
Telephone Number : 985-781-0548
Fax Number : 985-781-4319
Provider Business Practice Location Address
First Line : 137 N CLARK ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-5207
Country : US
Telephone Number : 985-781-0548
Fax Number : 985-781-4319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. GEORGANNA LEAVESLEY PHD” Practice Location

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