Provider Demographics
NPI:1497884381
Name:HUSAR, LEAH (OTR)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:HUSAR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 LIBERTY KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-8582
Mailing Address - Country:US
Mailing Address - Phone:571-263-1221
Mailing Address - Fax:
Practice Address - Street 1:31 STAFFORD AVE
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7246
Practice Address - Country:US
Practice Address - Phone:540-658-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004320225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist