Individual
LESLIE ANDERSON TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3007 PACES LAKE DR SE, ATLANTA, GA 30339-4263
(404) 547-7058
Mailing address
3007 PACES LAKE DR SE, ATLANTA, GA 30339-4263
(404) 547-7058
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
115029
TX
225X00000X
Occupational Therapist
OT006184
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
05
—
207164901
—
TX
Enumeration date
10/09/2012
Last updated
07/30/2015
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