Provider Demographics
NPI:1063812691
Name:BUCCHERI, LEAH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:BUCCHERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 CHURCHILL RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1708
Mailing Address - Country:US
Mailing Address - Phone:617-780-8223
Mailing Address - Fax:
Practice Address - Street 1:1 HUCKLEBERRY LN
Practice Address - Street 2:
Practice Address - City:FORESTDALE
Practice Address - State:MA
Practice Address - Zip Code:02644-1206
Practice Address - Country:US
Practice Address - Phone:508-932-8526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst