Leisure, Tina Marie
Leisure, Tina Marie is an sole proprietor health care provider with primary practice located at 3 Western Hills Dr , Parkersburg WV 26105-8122. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Leisure, Tina Marie can be contacted via phone (304) 420-1395.Contact Information
Primary practice address
3 Western Hills Dr
Parkersburg WV 26105-8122
Phone: (304) 420-1395
Fax: (304) 420-1364
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 684 | West Virginia |
Profile Details
| NPI number | 1184768491 |
|---|---|
| LBN Legal business name | Leisure, Tina Marie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 19th, 2007 |
| Last updated | Feb 27th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184768491 | NPPES |
| West Virginia | MEDICAID | 3810007824 |
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