Provider Demographics
NPI:1861488470
Name:LEAMAN, DAVID R (ED D)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:LEAMAN
Suffix:
Gender:M
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-1916
Mailing Address - Country:US
Mailing Address - Phone:717-762-7719
Mailing Address - Fax:717-762-1652
Practice Address - Street 1:131 W 5TH ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-1916
Practice Address - Country:US
Practice Address - Phone:717-762-7719
Practice Address - Fax:717-762-1652
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002731-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PALE005060OtherHIGHMARK
PA03004400OtherCAPITAL
LE005060Medicare ID - Type Unspecified