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1366132938
TABATHA LYNN LEISHMAN
CLEARLAKE, CA
NPI
1366132938
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-05-08
Last Update Date
2023-05-08
Business Address
TABATHA LYNN LEISHMAN SUDRC
7000B S CENTER DR
CLEARLAKE, CA 95422-8131
Phone number: 707-274-9101
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Mailing Address
TABATHA LYNN LEISHMAN SUDRC
13955 WALNUT WAY
CLEARLAKE OAKS, CA 95423-9690
Phone number: 707-354-1268
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