Healthcare Provider Details

I. General information

NPI: 1760563589
Provider Name (Legal Business Name): LEAH MORRISON FAME OCCUPATIONAL THERAPI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH KAY MORRISON OCCUPATIONAL THERAPI

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 WEST MAIN STREET HEARTLAND REHABILITATION SERVICES
SALEM VA
24153
US

IV. Provider business mailing address

844 WEST MAIN STREET HEARTLAND REHABILITATION SERVICES
SALEM VA
24153
US

V. Phone/Fax

Practice location:
  • Phone: 540-387-4311
  • Fax: 540-389-6212
Mailing address:
  • Phone: 540-387-4311
  • Fax: 540-389-6212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119000833
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: