Provider Demographics
NPI:1669529921
Name:LEIGHT, JENNIFER HOPE (PT, PHD, PCS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HOPE
Last Name:LEIGHT
Suffix:
Gender:F
Credentials:PT, PHD, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BANK ST STE 310
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4413
Mailing Address - Country:US
Mailing Address - Phone:406-531-1801
Mailing Address - Fax:
Practice Address - Street 1:206 ALASKA FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-7909
Practice Address - Country:US
Practice Address - Phone:406-531-1801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT405103T00000X
MT1086PT225100000X
PAPT008278L225100000X
IDPT1801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist