MEDICARE: ALESIA ANNE LEINGANG O.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OTT.Z12361	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821210576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALESIA ANNE LEINGANG O.T.

Provider Business Mailing Address
First Line	:	5208 ALEXANDER DR
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70003-2506
Country	:	US
Telephone Number	:	504-236-2088
Fax Number	:	504-281-4260

Provider Business Practice Location Address
First Line	:	5208 ALEXANDER DR
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70003-2506
Country	:	US
Telephone Number	:	504-236-2088
Fax Number	:	504-281-4260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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