Provider Demographics
NPI:1568643237
Name:NORDHUES, LESLI DEANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LESLI
Middle Name:DEANNE
Last Name:NORDHUES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 M AVE
Mailing Address - Street 2:
Mailing Address - City:CLARINDA
Mailing Address - State:IA
Mailing Address - Zip Code:51632-5058
Mailing Address - Country:US
Mailing Address - Phone:712-303-9948
Mailing Address - Fax:
Practice Address - Street 1:500 N BROAD ST
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-1318
Practice Address - Country:US
Practice Address - Phone:712-246-2268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01796225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist