Provider Demographics
NPI:1013108927
Name:LEONE, L MICHELLE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:L
Middle Name:MICHELLE
Last Name:LEONE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 N JACKSON ST
Mailing Address - Street 2:SUITE2-3
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2290
Mailing Address - Country:US
Mailing Address - Phone:931-393-7964
Mailing Address - Fax:931-455-6308
Practice Address - Street 1:1805 N JACKSON ST
Practice Address - Street 2:SUITE2-3
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2290
Practice Address - Country:US
Practice Address - Phone:931-393-7964
Practice Address - Fax:931-455-6308
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2305225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist