1841559465 NPI number — DR. CLAUDIA J LEONARD OTD, OT/L

Table of content: DR. CLAUDIA J LEONARD OTD, OT/L (NPI 1841559465)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841559465 NPI number — DR. CLAUDIA J LEONARD OTD, OT/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEONARD
Provider First Name:
CLAUDIA
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OTD, OT/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRUHNS
Provider Other First Name:
CLAUDIA
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841559465
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 785
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYARD
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88023-0785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-574-5177
Provider Business Mailing Address Fax Number:
575-574-5150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3131 AMHERST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUTTE
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59701-4653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-494-7035
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/16/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  2215 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com