Provider Demographics
NPI:1407575459
Name:LEACH, KASSANDRA D
Entity Type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:D
Last Name:LEACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22643 LAWSUIT LN
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-4133
Mailing Address - Country:US
Mailing Address - Phone:713-493-9388
Mailing Address - Fax:
Practice Address - Street 1:22643 LAWSUIT LN
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-4133
Practice Address - Country:US
Practice Address - Phone:713-493-9388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health