Provider Demographics
NPI:1033414164
Name:DE LEEUW, CHRISTINA MARIE (MS, MT-BC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:DE LEEUW
Suffix:
Gender:F
Credentials:MS, MT-BC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:HODABA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MT-BC
Mailing Address - Street 1:14 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5521
Mailing Address - Country:US
Mailing Address - Phone:812-679-6146
Mailing Address - Fax:
Practice Address - Street 1:14 SCENIC DR
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-5521
Practice Address - Country:US
Practice Address - Phone:812-679-6146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist