Provider Demographics
NPI:1821347386
Name:LEON, WILLIAM E
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:E
Last Name:LEON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 S 106TH ST
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-2264
Mailing Address - Country:US
Mailing Address - Phone:414-529-0109
Mailing Address - Fax:414-231-4010
Practice Address - Street 1:6110 S 106TH ST
Practice Address - Street 2:
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-2264
Practice Address - Country:US
Practice Address - Phone:414-231-4000
Practice Address - Fax:414-231-4010
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI448-1221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical