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NPI 1699801639

NPI 1699801639 : LEISA RENN'EE DICKEY-MONROE OT : BELMONT, NC

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General NPI Number Information
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    NPI Number           |    1699801639
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    Entity Type          |    Individual 
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    Provider Name        |    LEISA RENN'EE DICKEY-MONROE OT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/26/2007
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    Last Update Date     |    04/10/2025
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Provider Practice Location Address
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    Address Line         |    54 MYRTLE ST 
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    City                 |    BELMONT
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    State                |    NC
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    Zip                  |    28012-5200
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    Country              |    US
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    Telephone            |    704-954-8959
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    Fax                  |    980-207-2773
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Provider Business Mailing Address
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    Address Line         |    PO BOX 749 
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    City                 |    BELMONT
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    State                |    NC
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    Zip                  |    28012-0749
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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       |    2737
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    License Number State |    NC
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