Healthcare Provider Details

I. General information

NPI: 1528501707
Provider Name (Legal Business Name): LEIGH KAPPS PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 NW 14TH AVE
MIAMI FL
33125-1616
US

IV. Provider business mailing address

1411 NW 14TH AVE
MIAMI FL
33125-1616
US

V. Phone/Fax

Practice location:
  • Phone: 305-325-1529
  • Fax: 305-325-1044
Mailing address:
  • Phone: 305-325-1529
  • Fax: 305-325-1044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-03-1186
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: