Individual
LEESA GRADWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 HILLTOP DR # 14, BROOKHAVEN, PA 19015-1204
(610) 876-7821
Mailing address
5200 HILLTOP DR # 14, BROOKHAVEN, PA 19015-1204
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP003541L
PA
Other
Enumeration date
05/04/2008
Last updated
05/04/2008
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