Provider Demographics
NPI:1033296934
Name:CROWDER, LEIGH ANN
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:CROWDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 QUANTUM LAKES DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8324
Mailing Address - Country:US
Mailing Address - Phone:561-244-3627
Mailing Address - Fax:561-244-9627
Practice Address - Street 1:2500 QUANTUM LAKES DR
Practice Address - Street 2:SUITE 108
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8324
Practice Address - Country:US
Practice Address - Phone:561-244-3627
Practice Address - Fax:561-244-9627
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002280225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAOT002280OtherOCCUPATIONAL THERAPIST