Provider Demographics
NPI:1366127011
Name:KINZER, LEA MARIE (PLPC)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:MARIE
Last Name:KINZER
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7209 HAMILTON ACRES CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-8623
Mailing Address - Country:US
Mailing Address - Phone:423-499-9335
Mailing Address - Fax:
Practice Address - Street 1:150 SAINT PETERS CENTRE BLVD STE B
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1653
Practice Address - Country:US
Practice Address - Phone:636-345-4744
Practice Address - Fax:636-244-1171
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional