Individual
LESLIE WAYNE MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
619 N MAIN ST, JENNINGS, LA 70546-5347
(337) 824-8287
Mailing address
2002 JOHNSON ST STE 100, JENNINGS, LA 70546-3640
(337) 824-4547
(337) 824-4548
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.Z20608
LA
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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