Provider Demographics
NPI:1295191799
Name:KNAPP, LEAH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:
Last Name:KNAPP
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 WILDROSE AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-3411
Mailing Address - Country:US
Mailing Address - Phone:201-362-5680
Mailing Address - Fax:
Practice Address - Street 1:10 MINELL PL
Practice Address - Street 2:3
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5508
Practice Address - Country:US
Practice Address - Phone:201-362-5680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5316103TC0700X
NY020198103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical