Provider Demographics
NPI:1013608355
Name:LEON, KAITLINH KIERNAN
Entity Type:Individual
Prefix:
First Name:KAITLINH
Middle Name:KIERNAN
Last Name:LEON
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 1:2280 HIGHLAND VILLAGE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7184
Mailing Address - Country:US
Mailing Address - Phone:972-498-1307
Mailing Address - Fax:
Practice Address - Street 1:2280 HIGHLAND VILLAGE RD STE 150
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75077-7184
Practice Address - Country:US
Practice Address - Phone:972-498-1307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84587101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor