Provider Demographics
NPI:1598960726
Name:GUIMONT, LEAH JANE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:JANE
Last Name:GUIMONT
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 1:51 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-1815
Mailing Address - Country:US
Mailing Address - Phone:978-808-0694
Mailing Address - Fax:
Practice Address - Street 1:51 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940-1815
Practice Address - Country:US
Practice Address - Phone:978-808-0694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8065225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist