Provider Demographics
NPI:1154728970
Name:ISENBERG, LEIGH
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:ISENBERG
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 1:304 E H AVE
Mailing Address - Street 2:
Mailing Address - City:MILBURN
Mailing Address - State:OK
Mailing Address - Zip Code:73450-9428
Mailing Address - Country:US
Mailing Address - Phone:580-677-1899
Mailing Address - Fax:
Practice Address - Street 1:304 E H AVE
Practice Address - Street 2:
Practice Address - City:MILBURN
Practice Address - State:OK
Practice Address - Zip Code:73450-9428
Practice Address - Country:US
Practice Address - Phone:580-677-2214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor