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General NPI Number Information
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NPI Number | 1508165515
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Entity Type | Individual
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Provider Name | MARTA I LEAL LSW
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Gender | Female
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Dates
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Enumeration Date | 03/17/2011
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Last Update Date | 03/15/2025
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Provider Practice Location Address
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Address Line | 10427 DETROIT AVE
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City | CLEVELAND
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State | OH
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Zip | 44102-1645
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Country | US
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Telephone | 216-521-6511
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Fax |
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Provider Business Mailing Address
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Address Line | 10427 DETROIT AVE
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City | CLEVELAND
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State | OH
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Zip | 44102-1645
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Country | US
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Telephone | 440-785-2651
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0032059
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | S.0032059
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License Number State | OH
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