Leisa Bowler

Individual provider Active NPI Occupational Therapy Assistant · Lake Orion, MI

NPI 1487077830 · NPPES record last updated Jan 21, 2014

Key facts

NPI
1487077830
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
5202007677 (MI)
Practice address
2091 W View CT
Lake Orion, MI 48360-2287
Phone
(248) 421-8525
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
No

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
5202007677MIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5202007677 MI Yes

Addresses

Primary practice location

2091 W View CT
Lake Orion, MI 48360-2287

Mailing address

2091 W View CT
Lake Orion, MI 48360-2287
Phone (248) 421-8525

Other providers in Lake Orion, MI

All providers in Lake Orion, MI · Occupational Therapy Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.