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NPI Code Detail

MEDICARE: GRACE LEACH OTR/L

MEDICARE: GRACE LEACH OTR/L
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
1225XP0200XPediatric Occupational Therapist126355TX
2225XP0200XPediatric Occupational Therapist17-04456KS

General Provider Information

NPI Number : 1851180731
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE LEACH OTR/L
Provider Business Mailing Address
First Line : 9606 LEE BLVD
Second Line :
City : LEAWOOD
State : KS
Zip : 66206-2263
Country : US
Telephone Number : 913-558-5655
Fax Number :
Provider Business Practice Location Address
First Line : 320 CUSTER RD
Second Line :
City : RICHARDSON
State : TX
Zip : 75080-5623
Country : US
Telephone Number : 972-490-9055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2025
Last Update Date : 04/08/2026

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Directions to “ GRACE LEACH OTR/L” Practice Location

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