Healthcare Provider Details

I. General information

NPI: 1578562799
Provider Name (Legal Business Name): KATHRYN A LEINDECKER OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 MIDDLESEX TPKE
OLD SAYBROOK CT
06475-1220
US

IV. Provider business mailing address

71 LOVERS LN
EAST LYME CT
06333-1517
US

V. Phone/Fax

Practice location:
  • Phone: 860-388-8300
  • Fax: 860-388-8309
Mailing address:
  • Phone: 860-333-3187
  • Fax: 860-388-8309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number000472
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: