Individual
MS. ELLERI WYATT LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
1935 STATE ROAD 436 STE 1005, WINTER PARK, FL 32792-2244
(407) 629-9455
(407) 629-9138
Mailing address
1935 STATE ROAD 436 STE 1005, WINTER PARK, FL 32792-2244
(407) 629-9455
(407) 629-9138
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
OT10618
FL
225XP0200X
Pediatric Occupational Therapist
Primary
OT18517
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8881916100
—
FL
Enumeration date
10/20/2006
Last updated
08/14/2019
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