Individual
LEANNE KAYE GOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
N3492 JOHN ST, COLUMBUS, WI 53925-8912
(920) 763-2440
Mailing address
N3492 JOHN ST, COLUMBUS, WI 53925-8912
(920) 763-2440
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
608-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40704300
—
WI
Enumeration date
04/08/2008
Last updated
04/08/2008
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