Provider Demographics
NPI:1285864009
Name:LEET, FREDERIKA A
Entity Type:Individual
Prefix:MS
First Name:FREDERIKA
Middle Name:A
Last Name:LEET
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:FREDI
Other - Middle Name:
Other - Last Name:LEET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:43 LAKEVIEW TER
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43 LAKEVIEW TER
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1410
Practice Address - Country:US
Practice Address - Phone:203-426-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011626-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics