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NPI Code Detail

MEDICARE: JOHANNA LEIGHTY

MEDICARE: JOHANNA LEIGHTY
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1588855985
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHANNA LEIGHTY
Provider Business Mailing Address
First Line : 1475 FRANKLIN BLVD
Second Line :
City : EUGENE
State : OR
Zip : 97403
Country : US
Telephone Number : 541-302-3767
Fax Number :
Provider Business Practice Location Address
First Line : 550 RIVER RD
Second Line :
City : EUGENE
State : OR
Zip : 97404-3212
Country : US
Telephone Number : 541-689-8795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2007
Last Update Date : 10/18/2010

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Directions to “ JOHANNA LEIGHTY ” Practice Location

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