Healthcare Provider Details

I. General information

NPI: 1891742425
Provider Name (Legal Business Name): LEAH ODELL DARLING PT, LMT, NCTMB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 N NORTHSIGHT BLVD SUITE 102
SCOTTSDALE AZ
85260-3672
US

IV. Provider business mailing address

14300 N NORTHSIGHT BLVD SUITE 102
SCOTTSDALE AZ
85260-3672
US

V. Phone/Fax

Practice location:
  • Phone: 480-316-4555
  • Fax:
Mailing address:
  • Phone: 480-316-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33010467
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-13332
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8699
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: