Healthcare Provider Details

I. General information

NPI: 1104051325
Provider Name (Legal Business Name): LESLEY NICOLE NESMITH MA, OTR/L, ATP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 HAMLIN ST NE
WASHINGTON DC
20017-2451
US

IV. Provider business mailing address

1303 HAMLIN ST NE
WASHINGTON DC
20017-2451
US

V. Phone/Fax

Practice location:
  • Phone: 202-270-7928
  • Fax:
Mailing address:
  • Phone: 202-270-7928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberOT857
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: