Provider Demographics
NPI:1215826045
Name:LEONARD, DEBORAH N (DT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:N
Last Name:LEONARD
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4623 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-5008
Mailing Address - Country:US
Mailing Address - Phone:317-373-5076
Mailing Address - Fax:
Practice Address - Street 1:1540 W EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-9648
Practice Address - Country:US
Practice Address - Phone:317-531-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist