Provider Demographics
NPI:1609319847
Name:MOLINARO, LEANNE (M ED LBS)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:
Last Name:MOLINARO
Suffix:
Gender:F
Credentials:M ED LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3129 NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:DAISYTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15427-1004
Mailing Address - Country:US
Mailing Address - Phone:724-255-6477
Mailing Address - Fax:
Practice Address - Street 1:3129 NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:DAISYTOWN
Practice Address - State:PA
Practice Address - Zip Code:15427-1004
Practice Address - Country:US
Practice Address - Phone:724-255-6477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002001106S00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician