Provider Demographics
NPI:1477192060
Name:BROWN, LEAH MARIE I
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:BROWN
Suffix:I
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 1:104 LITCHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-2974
Mailing Address - Country:US
Mailing Address - Phone:717-503-6889
Mailing Address - Fax:
Practice Address - Street 1:104 LITCHFIELD RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2974
Practice Address - Country:US
Practice Address - Phone:717-503-6889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC006518L225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics