Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0588 | NV |
NPI | 1023235553 |
---|---|
Provider Name | Christen Leach |
First Address | Henderson, NV 89052-5843 |
Second Address | Henderson, NV 89052-5843 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 29/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100512190 | (05) | NV |