Provider Demographics
NPI:1184929762
Name:LEONARD, MEGHAN KATHLEEN (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:MEGHAN
Middle Name:KATHLEEN
Last Name:LEONARD
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 1:9225 N 3RD ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2439
Mailing Address - Country:US
Mailing Address - Phone:602-861-1218
Mailing Address - Fax:
Practice Address - Street 1:9225 N 3RD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2439
Practice Address - Country:US
Practice Address - Phone:602-861-1218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4719225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist