Provider Demographics
NPI:1639487929
Name:DUNLEAVY, LEAH (OTR/L, BCBA)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:DUNLEAVY
Suffix:
Gender:F
Credentials:OTR/L, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2783 SE INDIAN ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-5047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2783 SE INDIAN ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5047
Practice Address - Country:US
Practice Address - Phone:772-410-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-10298103K00000X
IL056.009846225XP0200X
FLOT23445225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst