Individual
TANYA LEAHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 RIVER AVE S, PRAIRIE FARM, WI 54762-9791
(715) 455-1178
Mailing address
PO BOX 52, CAMERON, WI 54822-0052
(715) 764-0212
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5129-27
WI
Other
Enumeration date
07/07/2015
Last updated
07/24/2015
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