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NPI Code Detail

MEDICARE: MS. KATHLEEN RAE LEONARD MA, MAC, CADCIII

MEDICARE: MS. KATHLEEN RAE LEONARD MA, MAC, CADCIII
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
1101YA0400XAddiction (Substance Use Disorder) Counselor900108OR

General Provider Information

NPI Number : 1821171745
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN RAE LEONARD MA, MAC, CADCIII
Provider Business Mailing Address
First Line : 4969 D ST
Second Line :
City : SPRINGFIELD
State : OR
Zip : 97478-6037
Country : US
Telephone Number : 541-741-6226
Fax Number : 541-682-2048
Provider Business Practice Location Address
First Line : 135 E 6TH AVE
Second Line :
City : EUGENE
State : OR
Zip : 97401-2618
Country : US
Telephone Number : 541-682-3965
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 07/08/2007

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Directions to “ MS. KATHLEEN RAE LEONARD MA, MAC, CADCIII” Practice Location

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