Provider Demographics
NPI:1740590520
Name:LEONARD, LAURA (MS BA BCBA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MS BA BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VERNEY DR.
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03047
Mailing Address - Country:US
Mailing Address - Phone:603-547-3311
Mailing Address - Fax:
Practice Address - Street 1:56 REGIONAL DR
Practice Address - Street 2:SUITE 7
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-547-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1-10-6893103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst