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General NPI Number Information
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NPI Number | 1427993286
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Entity Type | Individual
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Provider Name | KATHERINE GRACE LEACOMA
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Gender | Female
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 500 GRANITE AVE
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City | MILTON
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State | MA
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Zip | 02186-5626
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Country | US
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Telephone | 617-691-7140
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Fax |
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Provider Business Mailing Address
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Address Line | 47 CARPENTER RD
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City | WALPOLE
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State | MA
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Zip | 02081-3303
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 36505
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License Number State | MA
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