Provider Demographics
NPI:1063194728
Name:RODMAN, LEAH (BA, PSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:RODMAN
Suffix:
Gender:F
Credentials:BA, PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NW F ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2051
Mailing Address - Country:US
Mailing Address - Phone:541-474-5186
Mailing Address - Fax:541-474-5181
Practice Address - Street 1:301 NW F ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2051
Practice Address - Country:US
Practice Address - Phone:541-474-5186
Practice Address - Fax:541-474-5181
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor