Laura Sophia Liedtka, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

1127 Issued in MT

Practice address

1207 McDonald Ave Apt B
Missoula, MT 59801-9109

Phone

(406) 370-7176

NPI assigned

Jun 1, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1538453089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 MCDONALD AVE APT B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598019109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 MCDONALD AVE APT B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598019109",
            "telephone_number": "406-370-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEDTKA",
        "first_name": "LAURA",
        "middle_name": "SOPHIA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "MT",
            "license": "1127",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MT",
            "license": "1127",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT 00003449",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lezlie L McKenzie MSN Aprn BC PLLC
• Libby McIntyre, LCSW, Acsw, PLLC
• Tiara Z Liberty, C.M.T
• Victor Lewis Lieberman, PH.D.
• Diana Elizabeth Liedtka-Holmquist, DNP
• Life Chiropractic LLC
• Lift Aesthetic Surgery
• Stephanie Lynn Lighter, CNM, WHNP
• Lighthouse Speech Therapy PLLC
• Lightspace, Inc.

• Pediatric Occupational Therapist in Missoula, MT
• Providers in Missoula, MT by specialty
• Pediatric Occupational Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.