Provider Demographics
NPI:1033833926
Name:VENTIMIGLIA, LEAH (CMT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:VENTIMIGLIA
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8546 BOTHWELL RD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4109
Mailing Address - Country:US
Mailing Address - Phone:818-620-8454
Mailing Address - Fax:
Practice Address - Street 1:8546 BOTHWELL RD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4109
Practice Address - Country:US
Practice Address - Phone:818-620-8454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist