Provider Demographics
NPI:1891499703
Name:MCREE-KRIM, LEAH G
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:G
Last Name:MCREE-KRIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 SHOAL CREEK BLVD APT E
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1032
Mailing Address - Country:US
Mailing Address - Phone:352-359-0906
Mailing Address - Fax:
Practice Address - Street 1:1511 SHOAL CREEK BLVD APT E
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1032
Practice Address - Country:US
Practice Address - Phone:352-359-0906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120996225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist