Provider Demographics
NPI:1841326196
Name:HOPE, LEIGH TAYLOR (PSYD)
Entity type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:TAYLOR
Last Name:HOPE
Suffix:
Gender:F
Credentials:PSYD
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 372
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-0372
Mailing Address - Country:US
Mailing Address - Phone:315-825-5279
Mailing Address - Fax:
Practice Address - Street 1:40 MILFORD ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-1009
Practice Address - Country:US
Practice Address - Phone:315-825-5279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
VA0810003774103TC0700X
NY017997103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
030389866OtherTRICARE