Provider Demographics
NPI:1679188486
Name:LAWSON, ADA LESHEA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ADA
Middle Name:LESHEA
Last Name:LAWSON
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 1:1131 TERRY ST
Mailing Address - Street 2:
Mailing Address - City:RACELAND
Mailing Address - State:KY
Mailing Address - Zip Code:41169-1906
Mailing Address - Country:US
Mailing Address - Phone:606-939-4673
Mailing Address - Fax:
Practice Address - Street 1:1131 TERRY ST
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:KY
Practice Address - Zip Code:41169-1906
Practice Address - Country:US
Practice Address - Phone:606-939-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY266091225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist