Provider Demographics
NPI:1396262515
Name:DAVIS, LEAH ELIZABETH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:ELIZABETH
Last Name:DAVIS
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 1:970 TOWN CENTER DR.
Mailing Address - Street 2:SUITE C 100
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:267-609-3995
Mailing Address - Fax:
Practice Address - Street 1:970 TOWN CENTER DR.
Practice Address - Street 2:SUITE C 100
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:267-609-3995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042611055OtherTAX ID
MA1004745OtherFALLON
MA99618201OtherTUFTS HEALTH
MA1303287OtherMBHP
MA0000023532OtherBMC
MA1004745OtherNHP
MAM18633OtherBCBS