Provider Demographics
NPI:1891190559
Name:LEAP THERAPY, LLC
Entity Type:Organization
Organization Name:LEAP THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:PIPE-CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:559-303-6310
Mailing Address - Street 1:1083 SW MT MARKHAM PL
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-3502
Mailing Address - Country:US
Mailing Address - Phone:559-303-6310
Mailing Address - Fax:866-912-7692
Practice Address - Street 1:1083 SW MT MARKHAM PL
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3502
Practice Address - Country:US
Practice Address - Phone:559-303-6310
Practice Address - Fax:866-912-7692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health