Provider Demographics
NPI:1326161282
Name:LEAPS & BOUNDS PEDIATRIC THERAPY, INC
Entity Type:Organization
Organization Name:LEAPS & BOUNDS PEDIATRIC THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LESYK
Authorized Official - Last Name:LABAGH
Authorized Official - Suffix:
Authorized Official - Credentials:CCC SLP
Authorized Official - Phone:352-237-2292
Mailing Address - Street 1:3301 SW 34TH CIR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6621
Mailing Address - Country:US
Mailing Address - Phone:352-237-2292
Mailing Address - Fax:352-237-2236
Practice Address - Street 1:3301 SW 34TH CIR
Practice Address - Street 2:SUITE 202
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6621
Practice Address - Country:US
Practice Address - Phone:352-237-2292
Practice Address - Fax:352-237-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY908AOtherBLUE CROSS BLUE SHIELD