Provider Demographics
NPI:1225343205
Name:LEONARD, CHRISTINE GRACE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:GRACE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 COLUMBIA ST
Mailing Address - Street 2:APT 1S
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1532
Mailing Address - Country:US
Mailing Address - Phone:617-784-2902
Mailing Address - Fax:
Practice Address - Street 1:850 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1402
Practice Address - Country:US
Practice Address - Phone:617-349-6540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9703225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist