Provider Demographics
NPI:1336380575
Name:LEAMAN, JOAN E
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:LEAMAN
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 1:17 MALLISON FALLS RD
Mailing Address - Street 2:
Mailing Address - City:SO WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04082
Mailing Address - Country:US
Mailing Address - Phone:207-893-7142
Mailing Address - Fax:207-893-7157
Practice Address - Street 1:17 MALLISON FALLS RD
Practice Address - Street 2:
Practice Address - City:SO WINDHAME
Practice Address - State:ME
Practice Address - Zip Code:04082
Practice Address - Country:US
Practice Address - Phone:207-893-7142
Practice Address - Fax:207-893-7157
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC3889101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)