Individual
LARA NICOLE LEVENTHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
20320 NORTHWEST FWY STE 400A, JERSEY VILLAGE, TX 77065-5620
(725) 209-3053
(855) 927-7788
Mailing address
10680 MEDLOCK BRIDGE RD STE 101, JOHNS CREEK, GA 30097-8420
(725) 209-3053
(855) 927-7788
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
124309
TX
225X00000X
Occupational Therapist
15279
CA
Other
Enumeration date
04/19/2023
Last updated
09/26/2025
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