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General NPI Number Information
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NPI Number | 1669593455
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Entity Type | Individual
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Provider Name | DENISE REGINA LEATHERS OT
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/20/2009
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Provider Practice Location Address
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Address Line | 91 MAIN ST
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City | PLAISTOW
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State | NH
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Zip | 03865-3012
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Country | US
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Telephone | 603-382-3031
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 STATE RD
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City | ELIOT
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State | ME
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Zip | 03903-1087
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Country | US
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Telephone | 207-451-9120
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0A936
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1442
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2066
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License Number State | NH
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