Provider Demographics
NPI:1891320016
Name:LEONARDO, JAIMEE
Entity Type:Individual
Prefix:
First Name:JAIMEE
Middle Name:
Last Name:LEONARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 W CHESAPEAKE AVE STE 605
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4891
Mailing Address - Country:US
Mailing Address - Phone:410-583-1515
Mailing Address - Fax:
Practice Address - Street 1:40 W CHESAPEAKE AVE STE 605
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4891
Practice Address - Country:US
Practice Address - Phone:410-583-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician