Provider Demographics
NPI:1558104976
Name:MATHIEU, LEILA BENEDICT (DO)
Entity type:Individual
Prefix:MS
First Name:LEILA
Middle Name:BENEDICT
Last Name:MATHIEU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3586
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02304-3586
Mailing Address - Country:US
Mailing Address - Phone:774-213-1745
Mailing Address - Fax:
Practice Address - Street 1:1 CENTRE ST STE 900
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4095
Practice Address - Country:US
Practice Address - Phone:774-213-1745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula