Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner | ||
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | Z11380 | LA |
NPI | 1871704965 |
---|---|
Provider Name | Ms. Dina B Leighton |
First Address | Alexandria, LA 71315-3251 |
Second Address | Pineville, LA 71359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 11/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OTT211380 | OFFICE OF GROUP BENEFITS OF LA (01) | LA |