Provider Demographics
NPI:1043768559
Name:OMAN, LEAH (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:OMAN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16051-1837
Mailing Address - Country:US
Mailing Address - Phone:724-355-5488
Mailing Address - Fax:
Practice Address - Street 1:211 W PARK RD
Practice Address - Street 2:
Practice Address - City:PORTERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16051-1837
Practice Address - Country:US
Practice Address - Phone:724-355-5488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00606400225XP0200X
PAOC012033225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics