Provider Demographics
NPI:1740631555
Name:LEADBETTER, PAULA SARAH (RN LMT)
Entity type:Individual
Prefix:MISS
First Name:PAULA
Middle Name:SARAH
Last Name:LEADBETTER
Suffix:
Gender:F
Credentials:RN LMT
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Mailing Address - Street 1:6120 W BELL RD
Mailing Address - Street 2:150-12
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3781
Mailing Address - Country:US
Mailing Address - Phone:602-284-6207
Mailing Address - Fax:
Practice Address - Street 1:6120 W BELL RD
Practice Address - Street 2:150-12
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3781
Practice Address - Country:US
Practice Address - Phone:602-284-6207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ21819225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist