Basic Information
| Provider Information | |||||||||
| NPI: | 1740590520 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEONARD | ||||||||
| FirstName: | LAURA | ||||||||
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| Credential: | M.S BA B.C.B.A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 VERNEY DR. | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035473311 | ||||||||
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| Practice Location | |||||||||
| Address1: | 56 REGIONAL DR | ||||||||
| Address2: | SUITE 7 | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035473311 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2010 | ||||||||
| LastUpdateDate: | 05/22/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-10-6893 | NH | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.