Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 006023-1 | NY |
NPI | 1144732546 |
---|---|
Provider Name | Lorrie Leach |
First Address | Albany, NY 12208-1708 |
Second Address | Albany, NY 12208-1708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2017 |
Last Update Date | 26/10/2017 |