Leah Lackas, OTR/L

Individual provider Active NPI Occupational Therapist · Annandale, MN

NPI 1154740181 · NPPES record last updated Apr 7, 2014

Key facts

NPI
1154740181
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
104646 (MN)
Practice address
500 Park St E
Annandale, MN 55302-3060
Phone
(320) 274-3737
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
104646MNMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 104646 MN Yes

Addresses

Primary practice location

500 Park St E
Annandale, MN 55302-3060

Mailing address

500 Park St E
Annandale, MN 55302-3060

Other providers in Annandale, MN

All providers in Annandale, MN · Occupational Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.