=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184436214
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA LECKEY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2025
-----------------------------------------------------
Last Update Date | 01/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1700 PINE ST
-----------------------------------------------------
City | NORRISTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19401-3040
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-239-7100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5671 OLD EASTON RD
-----------------------------------------------------
City | DOYLESTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18902-9765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-622-1661
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 10389
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 125086
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OC020417
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------