Individual
MRS. LAURA ANN LEONHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225800000X
—
NY
Enumeration date
07/26/2006
Last updated
11/09/2009
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