Individual
LEHEA RENAE SCHUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
306 E NIZHONI BLVD, GALLUP, NM 87301-5794
(505) 863-9551
Mailing address
113 S OHIO ST, CHRISMAN, IL 61924-1525
(217) 822-3293
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.004112
IL
224Z00000X
Occupational Therapy Assistant
Primary
OTA4653
NM
Other
Enumeration date
04/05/2022
Last updated
04/25/2022
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