Healthcare Provider Details

I. General information

NPI: 1801080023
Provider Name (Legal Business Name): LEIGH ELLEN B. WATT OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 PALOMINO LN SUITE 401
BEDFORD NH
03110-6447
US

IV. Provider business mailing address

2 BOW CENTER RD
BOW NH
03304-4245
US

V. Phone/Fax

Practice location:
  • Phone: 603-667-7716
  • Fax:
Mailing address:
  • Phone: 603-225-9290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0706
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number0706
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: