Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS016634 | PA |
Y | 103T00000X | Psychologist | PS016634 | PA |
N | 103G00000X | Clinical Psychologist | PS016634PA | PA |
N | 103TC0700X | Clinical Psychologist | PS016634PA | PA |
NPI | 1013155027 |
---|---|
Provider Name | Dr. Danielle L. Leighty |
First Address | Johnstown, PA 15904-3307 |
Second Address | Johnstown, PA 15904-3327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2009 |
Last Update Date | 02/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000285381 | UNISON (01) | PA |
002106964 | HIGHMARK BLUE CROSS BLUE SHIELD (01) | PA |
1007708200003 | (05) | PA |
1023128880002 | (05) | PA |
1023128880003 | (05) | PA |
1023128880004 | (05) | PA |
164856RGD | MEDICARE (01) | PA |