Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT010734 | OH |
NPI | 1245836717 |
---|---|
Provider Name | Tanyalot Leibrant |
First Address | Cleveland, OH 44106-1702 |
Second Address | Cleveland, OH 44106-1702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2020 |
Last Update Date | 09/12/2020 |