Provider Demographics
NPI:1699253575
Name:ALDRICH, LEANN TAYLOR
Entity type:Individual
Prefix:MRS
First Name:LEANN
Middle Name:TAYLOR
Last Name:ALDRICH
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:PO BOX 1314
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47448-1314
Mailing Address - Country:US
Mailing Address - Phone:502-851-4356
Mailing Address - Fax:
Practice Address - Street 1:2040 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:IN
Practice Address - Zip Code:47448-9157
Practice Address - Country:US
Practice Address - Phone:502-851-4356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist