Individual
PATSY PENMAN LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
226 MAPLE AVENUE WEST, SUITE 202, SUITE 202, VIENNA, VA 22180-4737
(703) 242-2202
(703) 242-2206
Mailing address
226 MAPLE AVENUE WEST, SUITE 202, SUITE 202, VIENNA, VA 22180-4737
(703) 242-2202
(703) 242-2206
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119000736
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192718
PROVIDER NUMBER
VA
01
—
372912
INSURANCE PROVIDER NUMBER
VA
Enumeration date
10/23/2006
Last updated
03/16/2017
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