Provider Demographics
NPI:1821474750
Name:LEFLER, KRISTA (MSOT)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:LEFLER
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 S BROAD ST
Mailing Address - Street 2:STE 101
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-2255
Mailing Address - Country:US
Mailing Address - Phone:201-365-8989
Mailing Address - Fax:610-365-8994
Practice Address - Street 1:25 S BROAD ST
Practice Address - Street 2:STE 101
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-2255
Practice Address - Country:US
Practice Address - Phone:201-365-8989
Practice Address - Fax:610-365-8994
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC013526225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics