Provider Demographics
NPI:1811576242
Name:JARRETT, LEAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:JARRETT
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 1:1921 E CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-2116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:190 RIVER PARK DR
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-6844
Practice Address - Country:US
Practice Address - Phone:843-741-0082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-04
Last Update Date:2023-07-05
Deactivation Date:2023-05-30
Deactivation Code:
Reactivation Date:2023-07-05
Provider Licenses
StateLicense IDTaxonomies
SC4207225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist