Provider Demographics
NPI:1205188000
Name:LEALI, BRITTANY TAYLOR (LMT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:TAYLOR
Last Name:LEALI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24932 AURORA RD STE C
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1790
Mailing Address - Country:US
Mailing Address - Phone:440-439-5385
Mailing Address - Fax:440-439-5384
Practice Address - Street 1:27700 EUCLID AVE # B
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3531
Practice Address - Country:US
Practice Address - Phone:216-289-2632
Practice Address - Fax:216-289-2654
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.018004225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist