Provider Demographics
NPI:1366013450
Name:CURTIS, LESLIE M (COTA/L)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:M
Last Name:CURTIS
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 1:208 POMPANO DR SE APT A
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-6405
Mailing Address - Country:US
Mailing Address - Phone:727-641-9057
Mailing Address - Fax:
Practice Address - Street 1:208 POMPANO DR SE APT A
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-6405
Practice Address - Country:US
Practice Address - Phone:727-641-9057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant