Provider Demographics
NPI:1497236947
Name:LEAPS 'N BOUNDS THERAPY, PLLC
Entity Type:Organization
Organization Name:LEAPS 'N BOUNDS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CHAMBLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-712-4315
Mailing Address - Street 1:402 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-5117
Mailing Address - Country:US
Mailing Address - Phone:865-299-0093
Mailing Address - Fax:844-272-9718
Practice Address - Street 1:402 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-5117
Practice Address - Country:US
Practice Address - Phone:865-299-0093
Practice Address - Fax:844-272-9718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ041360Medicaid