Healthcare Provider Details

I. General information

NPI: 1841326196
Provider Name (Legal Business Name): LEIGH TAYLOR HOPE PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MILFORD ST
HAMILTON NY
13346-1009
US

IV. Provider business mailing address

PO BOX 372
HAMILTON NY
13346-0372
US

V. Phone/Fax

Practice location:
  • Phone: 315-825-5279
  • Fax:
Mailing address:
  • Phone: 315-825-5279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810003774
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number017997
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: