Healthcare Provider Details

I. General information

NPI: 1558751255
Provider Name (Legal Business Name): LEAH R ANDERSON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2015
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355 HUGUENARD DR STE 201
LEXINGTON KY
40503-3010
US

IV. Provider business mailing address

2355 HUGUENARD DR STE 201
LEXINGTON KY
40503-3010
US

V. Phone/Fax

Practice location:
  • Phone: 859-381-7620
  • Fax: 859-407-4696
Mailing address:
  • Phone: 859-381-7620
  • Fax: 859-407-4696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number264240
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number264240
License Number StateKY
# 6
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number264240
License Number StateKY
# 7
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number264240
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: