Provider Demographics
NPI:1700938529
Name:LEPPMA, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:LEPPMA
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 1:801 CARNATION DR
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-4907
Mailing Address - Country:US
Mailing Address - Phone:772-581-3083
Mailing Address - Fax:
Practice Address - Street 1:735 COMMERCE CENTER DR STE A
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3136
Practice Address - Country:US
Practice Address - Phone:772-589-4488
Practice Address - Fax:772-589-9027
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health