Individual
LAURA LEA BLEAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
2229 5TH AVE, HAVRE, MT 59501-5217
(406) 265-2620
Mailing address
3939 SHEPHERD RD N, HAVRE, MT 59501-6532
(406) 945-0675
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
649
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0341088
—
MT
Enumeration date
06/13/2007
Last updated
07/08/2007
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