Provider Demographics
NPI:1447024476
Name:TOKPA, LEEMU KORTO
Entity type:Individual
Prefix:
First Name:LEEMU
Middle Name:KORTO
Last Name:TOKPA
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 1:1717 40TH ST SW APT 219
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-4448
Mailing Address - Country:US
Mailing Address - Phone:510-823-3259
Mailing Address - Fax:
Practice Address - Street 1:1717 40TH ST SW APT 219
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4448
Practice Address - Country:US
Practice Address - Phone:510-823-3259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth