Bodhi Leaf, Pllc

NPI #1053779207 in Austin, Texas

Provider Information

NPI Number
1053779207
Entity Type
Organization
Organization Name
Bodhi Leaf, Pllc
Primary Specialty
Social Worker - Clinical
Enumeration Date
Feb 3, 2016
Last Updated
Feb 3, 2016

Practice Location

Address
1300 WEST LYNN DRIVE
Address 2
SUITE 207
City
Austin
State
Texas
ZIP Code
78703
Phone
(512) 653-4623

Authorized Official

Name
SASHI GABRIELLE KIMBALL, LCSW
Title
SOLE MEMBER
Phone
(512) 653-4623

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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