Healthcare Provider Details

I. General information

NPI: 1871704965
Provider Name (Legal Business Name): DINA B LEIGHTON L.O.T.R.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 DONAHUE FERRY RD
PINEVILLE LA
71360-4513
US

IV. Provider business mailing address

PO BOX 13251
ALEXANDRIA LA
71315-3251
US

V. Phone/Fax

Practice location:
  • Phone: 318-730-3632
  • Fax: 318-704-0775
Mailing address:
  • Phone: 318-730-3632
  • Fax: 318-704-0775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberOTZ11380
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOTTZ11380
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: