Provider Demographics
NPI:1144453499
Name:LEIDY, JANET B (MAC, LAC,)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:B
Last Name:LEIDY
Suffix:
Gender:F
Credentials:MAC, LAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-1928
Mailing Address - Country:US
Mailing Address - Phone:215-361-1619
Mailing Address - Fax:
Practice Address - Street 1:2121 SCHOOL RD
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-1928
Practice Address - Country:US
Practice Address - Phone:215-361-1619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000970171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist