Individual
MS. TERESA N LEIBFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
335 NE 10TH AVE, CRYSTAL RIVER, FL 34429-4456
(352) 795-5552
(352) 795-7751
Mailing address
3803 NW 47TH TER, GAINESVILLE, FL 32606-5992
(352) 376-5197
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
OT8392
FL
225XP0200X
Pediatric Occupational Therapist
Primary
OT 8392
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890815000
—
FL
01
—
Z073P
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/24/2006
Last updated
06/11/2008
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