Individual
MRS. ANN D LEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
S4555 HWY CH, REEDSBURG, WI 53959-9711
(608) 524-7511
(608) 524-7599
Mailing address
S4555 HWY CH, REEDSBURG, WI 53959-9711
(608) 524-7511
(608) 524-7599
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
274027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40671100
—
WI
Enumeration date
05/14/2008
Last updated
05/14/2008
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