Individual
LEIGH K TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1810 KENSINGTON DR, WAUKESHA, WI 53188-5616
(262) 548-1400
Mailing address
3101 WOODRIDGE LN, WAUKESHA, WI 53188-1328
(262) 524-8828
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1655027
WI
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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