Provider Demographics
NPI:1518466259
Name:SAWTELLE, LEAH (MT-BC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:SAWTELLE
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 VIRGINIA AVE N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55427-2550
Mailing Address - Country:US
Mailing Address - Phone:763-496-9449
Mailing Address - Fax:
Practice Address - Street 1:3101 VIRGINIA AVE N
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55427-2550
Practice Address - Country:US
Practice Address - Phone:763-496-9449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist