Provider Demographics
NPI:1871642850
Name:LEACH, ANNE M (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:LEACH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3557 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-4327
Mailing Address - Country:US
Mailing Address - Phone:419-385-4980
Mailing Address - Fax:419-385-8007
Practice Address - Street 1:1614 S BYRNE RD
Practice Address - Street 2:SUITE DD
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3464
Practice Address - Country:US
Practice Address - Phone:419-385-1290
Practice Address - Fax:419-385-8007
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00013351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical