Provider Demographics
NPI:1710015946
Name:LEEZER, JULIE MARIA (DEVELOPMENTAL THERAP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIA
Last Name:LEEZER
Suffix:
Gender:F
Credentials:DEVELOPMENTAL THERAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 COOKS MILL RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47122-9566
Mailing Address - Country:US
Mailing Address - Phone:812-989-2447
Mailing Address - Fax:
Practice Address - Street 1:9701 COOKS MILL RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:IN
Practice Address - Zip Code:47122-9566
Practice Address - Country:US
Practice Address - Phone:812-989-2247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist