Provider Demographics
NPI:1750486429
Name:ROCHELLE-WOODLEY, LEIGH (MSED; LMHC)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:ROCHELLE-WOODLEY
Suffix:
Gender:F
Credentials:MSED; LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:NY
Mailing Address - Zip Code:14519-9786
Mailing Address - Country:US
Mailing Address - Phone:315-524-7588
Mailing Address - Fax:315-524-7588
Practice Address - Street 1:2140 LAKE RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:NY
Practice Address - Zip Code:14519-9786
Practice Address - Country:US
Practice Address - Phone:315-524-7588
Practice Address - Fax:315-524-7588
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health