Provider Demographics
NPI:1508602111
Name:HACHE, LEONTYNE
Entity type:Individual
Prefix:
First Name:LEONTYNE
Middle Name:
Last Name:HACHE
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 1:200 E OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-1209
Mailing Address - Country:US
Mailing Address - Phone:614-589-9800
Mailing Address - Fax:614-589-9800
Practice Address - Street 1:200 E OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-1209
Practice Address - Country:US
Practice Address - Phone:614-589-9800
Practice Address - Fax:614-589-9800
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer