Provider Demographics
NPI:1982175477
Name:VERDIN, LEAH
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:VERDIN
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 1:1340 W TUNNEL BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2811
Mailing Address - Country:US
Mailing Address - Phone:985-293-7322
Mailing Address - Fax:985-231-1377
Practice Address - Street 1:1340 W TUNNEL BLVD STE 230
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2811
Practice Address - Country:US
Practice Address - Phone:985-293-7322
Practice Address - Fax:985-231-1377
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203783561101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health