MEDICARE: JULIE MARIE LEONETTI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	373H00000X	Day Training/Habilitation Specialist
2	3747A0650X	Attendant Care Provider
3	3747P1801X	Personal Care Attendant
4	374U00000X	Home Health Aide
5	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1700280732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE MARIE LEONETTI

Provider Business Mailing Address
First Line	:	3885 E 143RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-1012
Country	:	US
Telephone Number	:	216-505-5093
Fax Number	:

Provider Business Practice Location Address
First Line	:	3885 E 143RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-1012
Country	:	US
Telephone Number	:	216-505-5093
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2014
Last Update Date	:	10/20/2014

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