Provider Demographics
NPI:1548605991
Name:LEAPS AND BOUNDS THERAPEUTIC INTERVENTION, OT, SLP, PLLC
Entity Type:Organization
Organization Name:LEAPS AND BOUNDS THERAPEUTIC INTERVENTION, OT, SLP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CATERINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGNELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-713-4682
Mailing Address - Street 1:PO BOX 10064
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12552-0064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23 RAPELJE RD
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-2829
Practice Address - Country:US
Practice Address - Phone:845-713-4682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency