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1205471620
LEONARD LEROY MANN
WASILLA, AK
NPI
1205471620
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2019-11-08
Last Update Date
2021-02-03
Business Address
LEONARD LEROY MANN
3085 S ST MIHIEL CIR
WASILLA, AK 99654-0282
Phone number: 907-223-5371
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Mailing Address
LEONARD LEROY MANN
PO BOX 671872
CHUGIAK, AK 99567-1872
Phone number: 907-223-5371
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