Provider Demographics
NPI:1679143226
Name:LEONARD, TOMICA
Entity Type:Individual
Prefix:
First Name:TOMICA
Middle Name:
Last Name:LEONARD
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 1:2908 CLEARWATER ST NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-2214
Mailing Address - Country:US
Mailing Address - Phone:330-984-9591
Mailing Address - Fax:
Practice Address - Street 1:2908 CLEARWATER ST NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-2214
Practice Address - Country:US
Practice Address - Phone:330-984-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-27
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health