Provider Demographics
NPI:1164012407
Name:HOWARD, LEAH FAITH (BS, QMHP, RBT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:FAITH
Last Name:HOWARD
Suffix:
Gender:F
Credentials:BS, QMHP, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 BRANDYWINE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-7005
Mailing Address - Country:US
Mailing Address - Phone:757-969-8549
Mailing Address - Fax:
Practice Address - Street 1:780 LYNNHAVEN PKWY STE 370
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7353
Practice Address - Country:US
Practice Address - Phone:757-301-9065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-19-104976106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician