Healthcare Provider Details

I. General information

NPI: 1104606797
Provider Name (Legal Business Name): LEAH ONEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VANGILDER POINTE
MORGANTOWN WV
26505-3811
US

IV. Provider business mailing address

1 VANGILDER POINTE
MORGANTOWN WV
26505-3811
US

V. Phone/Fax

Practice location:
  • Phone: 208-805-5368
  • Fax:
Mailing address:
  • Phone: 208-805-5368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: