Provider Demographics
NPI:1982309431
Name:ALLEN, LEAH MARIE (CDP, CMDCP)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MARIE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CDP, CMDCP
Other - Prefix:MRS
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5658 JANIS DR
Mailing Address - Street 2:
Mailing Address - City:OSCODA
Mailing Address - State:MI
Mailing Address - Zip Code:48750-9277
Mailing Address - Country:US
Mailing Address - Phone:989-916-3082
Mailing Address - Fax:
Practice Address - Street 1:5658 JANIS DR
Practice Address - Street 2:
Practice Address - City:OSCODA
Practice Address - State:MI
Practice Address - Zip Code:48750-9277
Practice Address - Country:US
Practice Address - Phone:989-916-3082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator