Provider Demographics
NPI:1548037435
Name:LEARY, LA SONYA
Entity type:Individual
Prefix:
First Name:LA SONYA
Middle Name:
Last Name:LEARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 HARVEST HILLS DR APT 225
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-2667
Mailing Address - Country:US
Mailing Address - Phone:701-580-0228
Mailing Address - Fax:
Practice Address - Street 1:3001 HARVEST HILLS DR APT 225
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-2667
Practice Address - Country:US
Practice Address - Phone:701-580-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion