Individual
MYTISHA KAYLA LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
30 NUTMEG LN APT 219, EAST HARTFORD, CT 06118-1211
(860) 878-0759
Mailing address
30 NUTMEG LN APT 219, EAST HARTFORD, CT 06118-1211
(860) 878-0759
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5793
CT
Other
Enumeration date
11/06/2021
Last updated
11/06/2021
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