| NPI | 1811397110 |
|---|---|
| Former Name | CASEY LEAVENWORTH-KEENBERG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-21407) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2023-08-24 |