Provider Demographics
NPI:1659856896
Name:LEBLANC, ANNA JILL
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:JILL
Last Name:LEBLANC
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 1:15 GILSON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:NH
Mailing Address - Zip Code:03033-4418
Mailing Address - Country:US
Mailing Address - Phone:978-608-1667
Mailing Address - Fax:
Practice Address - Street 1:15 UNION ST STE 200
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1823
Practice Address - Country:US
Practice Address - Phone:978-604-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health