Healthcare Provider Details

I. General information

NPI: 1184666166
Provider Name (Legal Business Name): ROBERT LEA ED.D, LP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 BALTIMORE BLVD STE 311
WESTMINSTER MD
21157-6119
US

IV. Provider business mailing address

532 BALTIMORE BLVD STE 311
WESTMINSTER MD
21157-6119
US

V. Phone/Fax

Practice location:
  • Phone: 410-294-9612
  • Fax:
Mailing address:
  • Phone: 410-294-9612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number02076
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: