Provider Demographics
NPI:1386850527
Name:GAERKE, LEANN KAE (OTRL CHT)
Entity Type:Individual
Prefix:MRS
First Name:LEANN
Middle Name:KAE
Last Name:GAERKE
Suffix:
Gender:F
Credentials:OTRL CHT
Other - Prefix:MISS
Other - First Name:LEANN
Other - Middle Name:KAE
Other - Last Name:MICHAUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:6012 EL CAMINO DR
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-8630
Mailing Address - Country:US
Mailing Address - Phone:614-873-5837
Mailing Address - Fax:
Practice Address - Street 1:2050 KENNY RD STE 2100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3502
Practice Address - Country:US
Practice Address - Phone:614-293-0695
Practice Address - Fax:614-293-5220
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT2657225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
9811000053OtherCERTIFIED HAND THERAPIST