Individual
MRS. JESSICA TERRELL LEAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 MIDLAND TRL STE 1&2, SHELBYVILLE, KY 40065-8141
(502) 633-1007
Mailing address
1900 MIDLAND TRL STE 1&2, SHELBYVILLE, KY 40065-8141
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
T4005
KY
Other
Enumeration date
10/28/2008
Last updated
02/06/2012
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