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General NPI Number Information
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NPI Number | 1427890755
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Entity Type | Organization
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Legal Business Name | DR. TAKESHA LEONARD, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 2495 MAIN ST STE 466
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City | BUFFALO
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State | NY
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Zip | 14214-2135
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Country | US
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Telephone | 716-260-9320
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Fax |
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Provider Business Mailing Address
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Address Line | 2495 MAIN ST STE 466
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City | BUFFALO
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State | NY
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Zip | 14214-2135
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Country | US
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Telephone | 716-260-9320
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. TAKESHA L LEONARD
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Credential | PMHNP
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Telephone | 716-260-9320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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