MEDICARE: LAURENA J LEONARD-REICHEL OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT1925	ME

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00364512	OTHER	ME	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	098654	OTHER	ME	BLUE CROSS & BLUE SHIELD
2	OT1925	OTHER	ME	OT LICENSE

General Provider Information

NPI Number	:	1225074263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURENA J LEONARD-REICHEL OT

Provider Business Mailing Address
First Line	:	86 HUGHES BLVD
Second Line	:
City	:	HAMPDEN
State	:	ME
Zip	:	04444-1046
Country	:	US
Telephone Number	:	207-862-4062
Fax Number	:	866-220-5031

Provider Business Practice Location Address
First Line	:	86 HUGHES BLVD
Second Line	:
City	:	HAMPDEN
State	:	ME
Zip	:	04444-1046
Country	:	US
Telephone Number	:	207-862-4062
Fax Number	:	866-220-5031

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	09/30/2011

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Directions to “ LAURENA J LEONARD-REICHEL OT” Practice Location

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