Provider Demographics
NPI:1417513342
Name:LEONOFF, LINDSY MICHELLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDSY
Middle Name:MICHELLE
Last Name:LEONOFF
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LINDSY
Other - Middle Name:MICHELLE
Other - Last Name:RUGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N26W23977 WATERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1006
Mailing Address - Country:US
Mailing Address - Phone:262-523-0933
Mailing Address - Fax:
Practice Address - Street 1:N26W23977 WATERTOWN RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1006
Practice Address - Country:US
Practice Address - Phone:262-523-0933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6518-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist