Provider Demographics
NPI:1205687977
Name:LEONARD, HEATHER MARIE (MFT TRAINEE)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MFT TRAINEE
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:LIPARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:889 SAINT CHARLES DR APT 4
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4030
Mailing Address - Country:US
Mailing Address - Phone:805-907-2754
Mailing Address - Fax:
Practice Address - Street 1:864 E SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2939
Practice Address - Country:US
Practice Address - Phone:805-643-1446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program