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Individual

MRS. DENISE REGINA LEATHERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
91 MAIN ST, PLAISTOW, NH 03865-3012
(603) 382-3031
Mailing address
1776 STATE RD, ELIOT, ME 03903-1087
(207) 451-9120

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0A936
ME
224Z00000X
Occupational Therapy Assistant
1442
MA
225X00000X
Occupational Therapist
2066
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0A936
COTA
ME
01
1442
COTA
MA
01
2066
NEW HAMPSHIRE
NH
Enumeration date
04/02/2007
Last updated
07/20/2009
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