Provider Demographics
NPI:1831143841
Name:LEECH, BARBARA JANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JANE
Last Name:LEECH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 BRINTON CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4627
Mailing Address - Country:US
Mailing Address - Phone:610-436-4593
Mailing Address - Fax:
Practice Address - Street 1:770 E MARKET ST
Practice Address - Street 2:SUITE 180
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4883
Practice Address - Country:US
Practice Address - Phone:610-436-4593
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005656L103G00000X
NJSI00282400103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6512208Medicaid
NJR91077Medicare UPIN
NJ614447Medicare ID - Type Unspecified