EDA LEACH
Organization (NPI-2)
Active
Exclusive Provider Organization
Provider Information
- NPI Number
1619294634- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1746 DEN HERTOG ST SW, WYOMING, MI, 495193337
- Phone
- (616) 531-1142
- Fax
- (616) 531-1142
Specialties & Taxonomies
Social Worker
License: MI #638107811
Point of Service
License: MI #638107811
Exclusive Provider Organization
Primary License: MI #638107811