Provider Demographics
NPI:1376209361
Name:PARRENT, LEANNA R
Entity Type:Individual
Prefix:
First Name:LEANNA
Middle Name:R
Last Name:PARRENT
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 1:25100 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2207
Mailing Address - Country:US
Mailing Address - Phone:586-445-8181
Mailing Address - Fax:586-443-5591
Practice Address - Street 1:25100 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2207
Practice Address - Country:US
Practice Address - Phone:586-445-8181
Practice Address - Fax:586-443-5591
Is Sole Proprietor?:No
Enumeration Date:2021-11-13
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303040813183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician