Provider Demographics
NPI:1598478802
Name:GAILOR, LEAH MICHELLE
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:MICHELLE
Last Name:GAILOR
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 1:34399 BUCK CARROLL RD
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-3502
Mailing Address - Country:US
Mailing Address - Phone:225-369-3296
Mailing Address - Fax:
Practice Address - Street 1:34399 BUCK CARROLL RD
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-3502
Practice Address - Country:US
Practice Address - Phone:225-369-3296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-02
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling