Provider Demographics
NPI:1235814187
Name:POWERS, LEAH NICOLE (CPSS)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:NICOLE
Last Name:POWERS
Suffix:
Gender:F
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 BRECKENRIDGE ST APT 202
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2256
Mailing Address - Country:US
Mailing Address - Phone:859-576-4324
Mailing Address - Fax:
Practice Address - Street 1:561 BRECKENRIDGE ST APT 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2256
Practice Address - Country:US
Practice Address - Phone:859-576-4324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist