Provider Demographics
NPI:1538046800
Name:KNELLER, LEAH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:KNELLER
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 1:425 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-2816
Mailing Address - Country:US
Mailing Address - Phone:717-945-4672
Mailing Address - Fax:
Practice Address - Street 1:610 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-2308
Practice Address - Country:US
Practice Address - Phone:302-359-3734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health