Provider Demographics
NPI:1851691448
Name:LEONARD, TROY RICHARD (MA EDS LAC)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:RICHARD
Last Name:LEONARD
Suffix:
Gender:M
Credentials:MA EDS LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1125
Mailing Address - Country:US
Mailing Address - Phone:201-805-3480
Mailing Address - Fax:
Practice Address - Street 1:999 COLONIAL RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1125
Practice Address - Country:US
Practice Address - Phone:201-805-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor