Provider Demographics
NPI:1578290185
Name:FITZ-SIMON, LEAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:FITZ-SIMON
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 1:33500 N NORTH VALLEY PKWY UNIT 357
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-0012
Mailing Address - Country:US
Mailing Address - Phone:401-347-3437
Mailing Address - Fax:
Practice Address - Street 1:5220 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-2605
Practice Address - Country:US
Practice Address - Phone:623-691-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-008879225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist