Local City Search for Psychiatrists, Psychologists, Therapists, Counselors and Mental Health Treatment CentersMRS. PAMELA GAYLE LEISURE CCDC III
Addiction Substance Use Disorder
Watertown, South Dakota
Provider NPI: 1356337760
Provider Information:MRS. PAMELA GAYLE LEISURE CCDC III
Gender: F
Practice Location:
123 19TH ST NE WATERTOWN, SD 57201 US
Tel: 605-886-0123 Fax: 605-886-5447
Business Mailing Address:
PO BOX 1030 WATERTOWN, SD 57201 US
Tel: 605-886-0123 Fax: 605-886-5447
Entity Type: Individual
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | SD | 03071158 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ICADC | 23593 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
