Provider Demographics
NPI:1750190773
Name:LEECH, RAMONA LISA (MS)
Entity type:Individual
Prefix:
First Name:RAMONA
Middle Name:LISA
Last Name:LEECH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 PINEHILLS DR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-3314
Mailing Address - Country:US
Mailing Address - Phone:601-337-9995
Mailing Address - Fax:
Practice Address - Street 1:118 PINEHILLS DR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-3314
Practice Address - Country:US
Practice Address - Phone:601-337-9995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty