| NPI | 1255326161 |
|---|---|
| Former Name | LEEANN E BOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 3589-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 3589) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2007-07-08 |