Provider Demographics
NPI:1043033095
Name:BASHAW, LEAH (BA)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:BASHAW
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 OSWEENEY LN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4225
Mailing Address - Country:US
Mailing Address - Phone:614-707-8607
Mailing Address - Fax:
Practice Address - Street 1:6125 OSWEENEY LN
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-4225
Practice Address - Country:US
Practice Address - Phone:614-707-8607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services