| NPI | 1700173978 |
|---|---|
| Former Name | LEISHA JANE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 024813) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301014603) |
| 207R00000X Internal Medicine (Licence: NY 24813) | |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2023-07-17 |