Provider Demographics
NPI:1326329202
Name:MUNROE, LEIGHANNE
Entity Type:Individual
Prefix:
First Name:LEIGHANNE
Middle Name:
Last Name:MUNROE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OLD RUBBLY RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-1510
Mailing Address - Country:US
Mailing Address - Phone:978-927-2290
Mailing Address - Fax:
Practice Address - Street 1:12 OLD RUBBLY RD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1510
Practice Address - Country:US
Practice Address - Phone:978-927-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor