Provider Demographics
NPI:1154188498
Name:GRAYBILL, LEANNE LOUISE (WA, CCCCL61481090)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:LOUISE
Last Name:GRAYBILL
Suffix:
Gender:F
Credentials:WA, CCCCL61481090
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 MCPHEE RD SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-5014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA BARTOLOMEU MITRE 792
Practice Address - Street 2:C01
Practice Address - City:RIO DE JANEIRO
Practice Address - State:RIO DE JANEIRO
Practice Address - Zip Code:22431
Practice Address - Country:BR
Practice Address - Phone:717-805-3031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health