Provider Demographics
NPI:1043568082
Name:CARPENTER, LEIKKA GABRIELLE
Entity Type:Individual
Prefix:MRS
First Name:LEIKKA
Middle Name:GABRIELLE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 WALLER AVE
Mailing Address - Street 2:201
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2912
Mailing Address - Country:US
Mailing Address - Phone:859-270-9448
Mailing Address - Fax:
Practice Address - Street 1:343 WALLER AVE
Practice Address - Street 2:201
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2912
Practice Address - Country:US
Practice Address - Phone:859-270-9448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-23
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator