Healthcare Provider Details

I. General information

NPI: 1588451280
Provider Name (Legal Business Name): COLLEEN LESCHINSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5203 MARYLAND WAY STE 200
BRENTWOOD TN
37027-5022
US

IV. Provider business mailing address

5203 MARYLAND WAY STE 200
BRENTWOOD TN
37027-5022
US

V. Phone/Fax

Practice location:
  • Phone: 615-236-6566
  • Fax: 615-236-6566
Mailing address:
  • Phone: 615-236-6566
  • Fax: 615-236-6566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number529680
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: