Individual
MS. LEEANN EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR L
Contact information
Practice address
2778 COUNTRY CLUB DRIVE, HAMPSTEAD, NC 28443
(910) 821-1035
Mailing address
2778 COUNTRY CLUB DRIVE, HAMPSTEAD, NC 28443
(910) 821-1035
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4675
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
721634
—
NC
Enumeration date
08/31/2006
Last updated
09/18/2012
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