Provider Demographics
NPI:1689981219
Name:HUTCHISON, LEIGH ALISON (OT)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ALISON
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:HUTCHISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:2431 S LOOP 289
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1519
Mailing Address - Country:US
Mailing Address - Phone:806-771-8008
Mailing Address - Fax:806-771-8009
Practice Address - Street 1:2431 S LOOP 289
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1519
Practice Address - Country:US
Practice Address - Phone:806-771-8008
Practice Address - Fax:806-771-8009
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXOT107918225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218481401Medicaid
TX220029100OtherFIRSTCARE
TX218481402Medicaid
TX218481403Medicaid
TX847T27OtherBLUE CROSS BLUE SHIELD
TX220029100OtherFIRSTCARE