Leeroy Wainwright
Leeroy Wainwright is an Addiction (Substance Use Disorder) Counselor in San Pablo, California. Registered with an NPI since 2015.
- In the registry since
- 2015
Practice location Address checks out
1515 Market AveSan Pablo, CA 94806-4357
Phone: (510) 232-7571
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X |
|---|
Record details
| NPI number | 1154713766 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | February 19, 2015 |
| Last updated in NPPES | February 19, 2015 |
| Mailing address | 1515 Market Ave, San Pablo, CA 94806-4357 |
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