Provider Demographics
NPI:1154866622
Name:HARRINGTON, LEANNE (COTA/L)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:866 KENDUSKEAG AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-2910
Mailing Address - Country:US
Mailing Address - Phone:207-974-8435
Mailing Address - Fax:
Practice Address - Street 1:866 KENDUSKEAG AVE APT 1
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-2910
Practice Address - Country:US
Practice Address - Phone:207-974-8435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA2326224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant