Healthcare Provider Details

I. General information

NPI: 1487573994
Provider Name (Legal Business Name): LEAH FELICE EASTERLING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 VASSAR DR NE
ALBUQUERQUE NM
87106-2654
US

IV. Provider business mailing address

1447 VASSAR DR NE
ALBUQUERQUE NM
87106-2654
US

V. Phone/Fax

Practice location:
  • Phone: 505-424-1239
  • Fax: 505-808-7278
Mailing address:
  • Phone: 505-424-1239
  • Fax: 505-808-7278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2026-0113
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: